Provider Demographics
NPI:1033365713
Name:PAUL A. GREENBERG, M.D.,P.A.
Entity Type:Organization
Organization Name:PAUL A. GREENBERG, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-368-5835
Mailing Address - Street 1:8220 WALNUT HILL LN
Mailing Address - Street 2:SUITE 410
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4427
Mailing Address - Country:US
Mailing Address - Phone:214-368-5835
Mailing Address - Fax:214-368-0142
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:SUITE 410
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-368-5835
Practice Address - Fax:214-368-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB171OtherBLUE CROSS BLUE SHIELD
TXB88008Medicare UPIN
TXB171OtherBLUE CROSS BLUE SHIELD