Provider Demographics
NPI:1639504160
Name:CHO, PAUL INHO (PA-C)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:INHO
Last Name:CHO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 N BEACH ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-1505
Mailing Address - Country:US
Mailing Address - Phone:817-498-1818
Mailing Address - Fax:817-581-3761
Practice Address - Street 1:7510 N BEACH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-1505
Practice Address - Country:US
Practice Address - Phone:817-498-1818
Practice Address - Fax:817-581-3761
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10808363A00000X
PAMA056656363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA314425F6KOtherMEDICARE PTAN