Provider Demographics
NPI:1780396382
Name:PAULLA, LILIAN WILLIAM
Entity type:Individual
Prefix:
First Name:LILIAN
Middle Name:WILLIAM
Last Name:PAULLA
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 1:5558 EMERSON CT
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75069-6809
Mailing Address - Country:US
Mailing Address - Phone:972-900-1745
Mailing Address - Fax:
Practice Address - Street 1:5558 EMERSON CT
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TX
Practice Address - Zip Code:75069-6809
Practice Address - Country:US
Practice Address - Phone:972-900-1745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1099807363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health