MEDICARE: PAUL CHII

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TM1800X	Intellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number	:	1013398262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL CHII

Provider Business Mailing Address
First Line	:	2508 REDBUD AVE
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79761-1616
Country	:	US
Telephone Number	:	301-828-7223
Fax Number	:

Provider Business Practice Location Address
First Line	:	2508 REDBUD AVE
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79761-1616
Country	:	US
Telephone Number	:	301-828-7223
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2015
Last Update Date	:	06/13/2015

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Directions to “ PAUL CHII ” Practice Location

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