Organization Name: | PAUL S. WORRELL, D.O., P.A. |
NPI Number: | 1093925620 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FREDDIE TOMBLIN (OFFICE MANAGER) |
Mailing Address: | 8668 Skillman St Dallas |
State: | TX US |
Postal Code: | 752438216 |
Phone Number: | 2143494909 |
Fax Number: | 2143494973 |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 04/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | F7329 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |