Provider Demographics
NPI:1790786812
Name:PAGLEY, PAUL R (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:PAGLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7800 SHOAL CREEK BLVD
Mailing Address - Street 2:205-N
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1098
Mailing Address - Country:US
Mailing Address - Phone:512-206-4341
Mailing Address - Fax:512-407-1947
Practice Address - Street 1:900 W 38TH ST
Practice Address - Street 2:STE 400
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1127
Practice Address - Country:US
Practice Address - Phone:512-206-3600
Practice Address - Fax:512-206-3604
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2022-01-27
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Provider Licenses
StateLicense IDTaxonomies
TXL5864207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1552085 01Medicaid
TX1552085 01Medicaid
TXTXB108935Medicare PIN
TX8A2011Medicare PIN