Healthcare Provider Details

I. General information

NPI: 1174567457
Provider Name (Legal Business Name): PAUL A PLAYFAIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 BEE CAVES RD
AUSTIN TX
78746-5280
US

IV. Provider business mailing address

PO BOX 153105
LUFKIN TX
75915-3105
US

V. Phone/Fax

Practice location:
  • Phone: 936-639-3036
  • Fax: 936-639-3064
Mailing address:
  • Phone: 936-639-3036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberK1000
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: