Provider Demographics
NPI:1184903361
Name:PALUMBO, PAUL MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:PALUMBO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:22741 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6005
Mailing Address - Country:US
Mailing Address - Phone:281-319-4334
Mailing Address - Fax:281-319-4855
Practice Address - Street 1:22741 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6005
Practice Address - Country:US
Practice Address - Phone:281-319-4334
Practice Address - Fax:281-319-4855
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7715TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX287247501Medicaid
TX287247502Medicaid
TX287247503Medicaid
TX287247502Medicaid
TX287247503Medicaid
TXTXB142114Medicare PIN