Fillable Reynolds 450 Medical Center Blvd - tdi texas

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Texas Department of Insurance, Division of Workers' Compensation 7551 Metro Center Drive, Suite 100 Austin, Texas 78744-1609 MEDICAL DISPUTE RESOLUTION FINDINGS AND DECISION PART I: GENERAL INFORMATION Type of Requestor: (x) Health Care Provider ( ) Injured Employee ( ) Insurance Carrier Requestor's Name and Address: Dr. Ian J. Reynolds 450 Medical Center Blvd. #206 Webster, TX 77598 Respondent's Name: New...
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