Provider Demographics
NPI:1942288279
Name:SKLUZACEK, PAUL A (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:SKLUZACEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 660132
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0132
Mailing Address - Country:US
Mailing Address - Phone:214-358-2300
Mailing Address - Fax:214-366-6127
Practice Address - Street 1:1150 N BISHOP AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4167
Practice Address - Country:US
Practice Address - Phone:214-358-2300
Practice Address - Fax:214-366-6461
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5912207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159472302Medicaid
TXP00347554Medicare PIN
TX8G4799Medicare PIN
TXH86229Medicare UPIN