Provider Demographics
NPI:1780737817
Name:HUME, PAUL J (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:HUME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3128 RICHARD LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2874
Mailing Address - Country:US
Mailing Address - Phone:225-802-6827
Mailing Address - Fax:
Practice Address - Street 1:1505 E WINDING WAY DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5394
Practice Address - Country:US
Practice Address - Phone:281-993-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99147207Q00000X
LAL026189207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1049662Medicaid
FLAF170ZMedicare PIN
LAI12502Medicare UPIN
LA4F944C822Medicare PIN