Provider Demographics
NPI:1508861188
Name:LOEFFLER, PAUL W (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:W
Last Name:LOEFFLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S STAPLES ST
Mailing Address - Street 2:STE 102
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-3844
Mailing Address - Country:US
Mailing Address - Phone:361-854-7000
Mailing Address - Fax:361-814-2685
Practice Address - Street 1:5959 S STAPLES ST
Practice Address - Street 2:STE 102
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3844
Practice Address - Country:US
Practice Address - Phone:361-854-7000
Practice Address - Fax:361-814-2685
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3143174400000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136249301Medicaid
TXE01731Medicare UPIN
TX841513Medicare ID - Type UnspecifiedMEDICARE