Provider Demographics
NPI:1588678197
Name:PAPAILA, JOHN GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GREGORY
Last Name:PAPAILA
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 1:1419 N TRAVIS ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-3757
Mailing Address - Country:US
Mailing Address - Phone:903-893-4244
Mailing Address - Fax:903-893-9517
Practice Address - Street 1:1419 N TRAVIS ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-3757
Practice Address - Country:US
Practice Address - Phone:903-893-4244
Practice Address - Fax:903-893-9517
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0624174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE50567Medicare UPIN
TX8801B1Medicare PIN