Provider Demographics
NPI:1508896739
Name:ROBERT W. PAIGE M. D. P. A.
Entity Type:Organization
Organization Name:ROBERT W. PAIGE M. D. P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-351-1560
Mailing Address - Street 1:PO BOX 50360
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-0360
Mailing Address - Country:US
Mailing Address - Phone:806-351-1560
Mailing Address - Fax:806-351-0343
Practice Address - Street 1:7120 W INTERSTATE 40
Practice Address - Street 2:SUITE 400
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2526
Practice Address - Country:US
Practice Address - Phone:806-351-1560
Practice Address - Fax:806-351-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7230207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMF80OtherBLUE CROSS & BLUE SHIELD
TX0071086-01Medicaid
TXTXB113142Medicare PIN