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General NPI Number Information
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NPI Number | 1609913326
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Entity Type | Organization
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Legal Business Name | THE PAULL ALLERGY & ASTHMA CLINIC, P.A
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 3201 UNIVERSITY DR E STE 245
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City | BRYAN
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State | TX
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Zip | 77802
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Country | US
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Telephone | 979-776-0700
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Fax | 979-776-5624
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Provider Business Mailing Address
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Address Line | 3201 UNIVERSITY DR E STE 245
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City | BRYAN
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State | TX
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Zip | 77802
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Country | US
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Telephone | 979-776-0700
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Fax | 979-776-5624
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEITH J PAULL
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Credential | MD
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Telephone | 979-776-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | L8161
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License Number State | TX
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