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General NPI Number Information
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NPI Number | 1871521567
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Entity Type | Individual
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Provider Name | PAUL A REDER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 34910 INTERSTATE 10 W
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City | BOERNE
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State | TX
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Zip | 78006-9229
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Country | US
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Telephone | 361-994-4880
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Fax | 361-994-4890
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Provider Business Mailing Address
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Address Line | 1620 N MAIN ST
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City | SPANISH FORK
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State | UT
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Zip | 84660-1008
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Country | US
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Telephone | 801-822-2234
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Fax |
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 101249
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | J7153
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License Number State | TX
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