Provider Demographics
NPI:1942431341
Name:PASCHAL, SHAE BRYAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:SHAE
Middle Name:BRYAN
Last Name:PASCHAL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3050 S CENTER ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2022
Mailing Address - Country:US
Mailing Address - Phone:817-557-1006
Mailing Address - Fax:817-557-2000
Practice Address - Street 1:3050 S CENTER ST
Practice Address - Street 2:SUITE 140
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2022
Practice Address - Country:US
Practice Address - Phone:817-557-1006
Practice Address - Fax:817-557-2000
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL9537213ES0103X
TX1904213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L25635Medicare UPIN