MEDICARE: JULIE PAO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	H3595	TX
2	207VG0400X	Gynecology Physician	H3595	TX
3	207VM0101X	Maternal & Fetal Medicine Physician	H3595	TX
4	207VX0000X	Obstetrics Physician	H3595	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	943418344	OTHER	TX	TAX ID

General Provider Information

NPI Number	:	1275539025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE PAO MD

Provider Business Mailing Address
First Line	:	PO BOX 660046
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75266-0046
Country	:	US
Telephone Number	:	214-369-8555
Fax Number	:

Provider Business Practice Location Address
First Line	:	12200 PARK CENTRAL DR
Second Line	:	STE 403
City	:	DALLAS
State	:	TX
Zip	:	75251-2126
Country	:	US
Telephone Number	:	972-774-9990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	12/29/2008

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Directions to “ JULIE PAO MD” Practice Location

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