Provider Demographics
NPI:1952728917
Name:PALMER, PAUL EDWIN III
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EDWIN
Last Name:PALMER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 WONDER WORLD DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7541
Mailing Address - Country:US
Mailing Address - Phone:512-353-6400
Mailing Address - Fax:512-353-3039
Practice Address - Street 1:1305 WONDER WORLD DR STE 300
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7541
Practice Address - Country:US
Practice Address - Phone:512-353-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS0351208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery