Provider Demographics
NPI:1235306127
Name:WOODRUFF, PAUL FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FRANK
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 S STAPLES ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2952
Mailing Address - Country:US
Mailing Address - Phone:361-992-9200
Mailing Address - Fax:361-992-7960
Practice Address - Street 1:6000 S STAPLES ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2952
Practice Address - Country:US
Practice Address - Phone:361-992-9200
Practice Address - Fax:361-992-7960
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-11
Last Update Date:2008-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice