Provider Demographics
NPI:1851368906
Name:LIFLAND, PAUL DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:DENNIS
Last Name:LIFLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78104-0699
Mailing Address - Country:US
Mailing Address - Phone:361-362-9938
Mailing Address - Fax:361-358-8677
Practice Address - Street 1:400 ROSALIND REFERN GROVER PARKWAY
Practice Address - Street 2:MIDLAND MEMORIAL HOSPITAL
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701
Practice Address - Country:US
Practice Address - Phone:432-221-1111
Practice Address - Fax:432-582-8690
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7180207X00000X, 207XS0114X, 207XX0005X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX760294637OtherTEXAS ASSOCIATION OF COUNTIES
TX096930502Medicaid
TX09-00570OtherEVERCARE STAR PLUS
TX2635OtherBLUE CROSS
TX6346564OtherCIGNA
TX5617730OtherAETNA
TX760294637OtherHUMANA
TX6346564OtherCIGNA
TX096930502Medicaid