Provider Demographics
NPI:1609871193
Name:REINHART, PAUL A (PA)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:A
Last Name:REINHART
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HAWTHORNE PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78374-1428
Mailing Address - Country:US
Mailing Address - Phone:361-643-1742
Mailing Address - Fax:361-643-1742
Practice Address - Street 1:4141 S. STAPLES SUITE 300
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2929
Practice Address - Country:US
Practice Address - Phone:361-882-5560
Practice Address - Fax:361-882-6011
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00040363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCK7292OtherMEDICARE RAILROAD
TX0040EEOtherBLUE CROSS BLUE SHIELD
TX87N264OtherBLUE CROSS BLUE SHIELD
TX970030081OtherMEDICARE RAILROAD
TX83N547Medicare PIN
TXCK7292OtherMEDICARE RAILROAD