Provider Demographics
NPI:1710202353
Name:PAEZ, VLADIMIR (MD)
Entity Type:Individual
Prefix:MR
First Name:VLADIMIR
Middle Name:
Last Name:PAEZ
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 1:153 NORTHRIDGE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-2556
Mailing Address - Country:US
Mailing Address - Phone:832-475-4115
Mailing Address - Fax:
Practice Address - Street 1:153 NORTHRIDGE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-2556
Practice Address - Country:US
Practice Address - Phone:832-475-4115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR9831207R00000X
TXBP10057862207R00000X
TX10-116
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine