Healthcare Provider Details

I. General information

NPI: 1649720665
Provider Name (Legal Business Name): FRANK PAUL D.O. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5523 S EASTERN AVE
LAS VEGAS NV
89119-2312
US

IV. Provider business mailing address

PO BOX 95584
LAS VEGAS NV
89193-5584
US

V. Phone/Fax

Practice location:
  • Phone: 702-463-4050
  • Fax: 702-463-7881
Mailing address:
  • Phone: 702-463-4050
  • Fax: 702-463-7881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANK ALLEN PAUL
Title or Position: PRESIDENT
Credential: D.O.
Phone: 313-506-6314