Provider Demographics
NPI:1003981556
Name:ST. PAUL ERDOCS, P.A.
Entity Type:Organization
Organization Name:ST. PAUL ERDOCS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:PILLOW
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:214-712-2448
Mailing Address - Street 1:5909 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390
Mailing Address - Country:US
Mailing Address - Phone:214-712-2775
Mailing Address - Fax:214-712-2444
Practice Address - Street 1:5909 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390
Practice Address - Country:US
Practice Address - Phone:214-645-5582
Practice Address - Fax:214-712-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0094GHOtherTX BLUECROSS
TX=========OtherCHAMPUS