Provider Demographics
NPI:1881678779
Name:VOGEL, PAULA SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:SUE
Last Name:VOGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2632 BROADWAY ST STE 201N
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1145
Mailing Address - Country:US
Mailing Address - Phone:210-226-0040
Mailing Address - Fax:210-226-0050
Practice Address - Street 1:2632 BROADWAY ST
Practice Address - Street 2:SUITE 401N
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1147
Practice Address - Country:US
Practice Address - Phone:210-226-0040
Practice Address - Fax:210-226-0050
Is Sole Proprietor?:No
Enumeration Date:2005-12-04
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9447207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI48119Medicare UPIN
TX8G2976Medicare ID - Type Unspecified