MEDICARE: WILLIAM ANTHONY PARUOLO M.D.

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	208000000X	Pediatrics Physician	K8409	TX

General Provider Information

NPI Number	:	1073564613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ANTHONY PARUOLO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 733784
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75373-3784
Country	:	US
Telephone Number	:	682-885-6483
Fax Number	:	682-885-3113

Provider Business Practice Location Address
First Line	:	225 W LEBANON RD
Second Line	:	SUITE 104
City	:	FRISCO
State	:	TX
Zip	:	75036-3412
Country	:	US
Telephone Number	:	972-370-2425
Fax Number	:	972-370-2591

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	01/25/2023

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