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General NPI Number Information
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NPI Number | 1548318637
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Entity Type | Individual
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Provider Name | PAULA G. LAND PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 108 BRENTWOOD DR
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City | LEVELLAND
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State | TX
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Zip | 79336-6604
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Country | US
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Telephone | 505-257-2100
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Fax | 505-257-1450
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Provider Business Mailing Address
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Address Line | 123 SLEEPY HOLLOW RD
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City | RUIDOSO
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State | NM
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Zip | 88345-6318
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Country | US
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Telephone | 505-257-2100
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Fax | 505-257-1450
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 23311
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License Number State | TX
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