Provider Demographics
NPI:1780896829
Name:PAULSON, STEPHEN M (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:PAULSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8401 DATAPOINT DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5900
Mailing Address - Country:US
Mailing Address - Phone:210-614-0180
Mailing Address - Fax:210-615-7170
Practice Address - Street 1:8401 DATAPOINT DR
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5900
Practice Address - Country:US
Practice Address - Phone:210-614-0180
Practice Address - Fax:210-615-7170
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2016-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO44621207P00000X
TXN2237207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200602519OtherCSHCN
TX8CE097OtherBCBSTX
TX200602518Medicaid
TX200602507Medicaid
TX8BX249OtherBCBS OF TX
TX200602518Medicaid
TX200602507Medicaid
TX277256YK00Medicare UPIN
TX8L21686Medicare PIN