Provider Demographics
NPI:1144209354
Name:BESSONETT, PAULA ALINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:ALINDA
Last Name:BESSONETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 131736
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75713
Mailing Address - Country:US
Mailing Address - Phone:903-509-2492
Mailing Address - Fax:903-617-6122
Practice Address - Street 1:222 E. FIFTH STREET
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701
Practice Address - Country:US
Practice Address - Phone:903-509-2492
Practice Address - Fax:903-617-6122
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4166207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139617820Medicaid
TXE30946Medicare UPIN