Healthcare Provider Details

I. General information

NPI: 1770677403
Provider Name (Legal Business Name): MICHAEL MAURICE PAULSEN RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOLCOMBE BLVD
HOUSTON TX
77030
US

IV. Provider business mailing address

5602 COTTONWOOD ST.
PEARLAND TX
77584
US

V. Phone/Fax

Practice location:
  • Phone: 713-791-1414
  • Fax:
Mailing address:
  • Phone: 281-692-1244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number69056
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: