Provider Demographics
NPI:1912995622
Name:MAYES, PAUL E (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:MAYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2129 W DAVIS ST
Mailing Address - Street 2:D
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1942
Mailing Address - Country:US
Mailing Address - Phone:936-788-1600
Mailing Address - Fax:936-788-1601
Practice Address - Street 1:2129 W DAVIS ST
Practice Address - Street 2:D
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1942
Practice Address - Country:US
Practice Address - Phone:936-788-1600
Practice Address - Fax:936-788-1601
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA12292R208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
G47488Medicare UPIN
G47488Medicare UPIN
5Y468Medicare ID - Type Unspecified