=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841237104
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAUL H KARAKOURTIS MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2006
-----------------------------------------------------
Last Update Date | 07/09/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1926 SW GREEN OAKS BLVD
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76017-2735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-472-5522
-----------------------------------------------------
Fax | 817-472-7303
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1926 SW GREEN OAKS BLVD
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76017-2735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-472-5522
-----------------------------------------------------
Fax | 817-472-7303
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | J4255
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | J4255
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------