Provider Demographics
NPI:1720180664
Name:NAIRNE, PAULETTE JEAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:JEAN
Last Name:NAIRNE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:P
Other - Middle Name:J
Other - Last Name:NAIRNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:407 N CEDAR RIDGE DR
Mailing Address - Street 2:STE 225
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3169
Mailing Address - Country:US
Mailing Address - Phone:972-816-6030
Mailing Address - Fax:972-299-9998
Practice Address - Street 1:407 N CEDAR RIDGE DR
Practice Address - Street 2:STE 225
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3169
Practice Address - Country:US
Practice Address - Phone:972-816-6030
Practice Address - Fax:972-299-9998
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1468213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018595101Medicaid
TX177282401Medicaid
TX018595102Medicaid
TXT87509Medicare UPIN
TX018595102Medicaid
TX5312260001Medicare NSC