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NPI Code Detail

MEDICARE: PAUL WILLIAM GIDLEY M.D.

MEDICARE: PAUL WILLIAM GIDLEY 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
1207Y00000XOtolaryngology PhysicianJ0827TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18B5500OTHERTXBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275526550
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL WILLIAM GIDLEY M.D.
Provider Business Mailing Address
First Line : P O BOX 4439
Second Line :
City : HOUSTON
State : TX
Zip : 77210-4439
Country : US
Telephone Number : 713-792-2991
Fax Number :
Provider Business Practice Location Address
First Line : 1515 HOLCOMBE BLVD
Second Line : 441
City : HOUSTON
State : TX
Zip : 77030-4009
Country : US
Telephone Number : 713-792-6920
Fax Number : 713-794-4662
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 05/28/2019

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