Provider Demographics
NPI:1952558090
Name:FROUDE, PAUL S (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:FROUDE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14000 STACEY VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-0804
Mailing Address - Country:US
Mailing Address - Phone:912-414-7527
Mailing Address - Fax:
Practice Address - Street 1:14000 STACEY VALLEY DR
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-0804
Practice Address - Country:US
Practice Address - Phone:912-414-7527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013857122300000X
TX379741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist