Provider Demographics
NPI:1891731501
Name:JUREK, PAUL A (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:JUREK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 ANDREWS HWY
Mailing Address - Street 2:SUITE 304A
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-3915
Mailing Address - Country:US
Mailing Address - Phone:432-520-6016
Mailing Address - Fax:432-694-9700
Practice Address - Street 1:1031 ANDREWS HWY
Practice Address - Street 2:SUITE 304A
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-3915
Practice Address - Country:US
Practice Address - Phone:432-520-6016
Practice Address - Fax:432-694-9700
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1121101Y00000X
TX000634106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5846089OtherAETNA
TX2886LCOtherBCBS
TX125331OtherSUPERIOR CHIPS
TX212890OtherCOMP PSYCH