Provider Demographics
NPI:1922862739
Name:PASCHAL, MAKALA PAIGE
Entity Type:Individual
Prefix:
First Name:MAKALA
Middle Name:PAIGE
Last Name:PASCHAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10421 FALLEN LEAF DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-2004
Mailing Address - Country:US
Mailing Address - Phone:254-644-1625
Mailing Address - Fax:
Practice Address - Street 1:319 S STATE HIGHWAY 36 BYPASS STE 401
Practice Address - Street 2:
Practice Address - City:GATESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76528
Practice Address - Country:US
Practice Address - Phone:254-248-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF02240248363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily