MEDICARE: ELIZABETH PAUL NP-FAMILY

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	163W00000X	Registered Nurse	894838	TX
2	363LF0000X	Family Nurse Practitioner	1042955	TX

General Provider Information

NPI Number	:	1427693639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH PAUL NP-FAMILY

Provider Business Mailing Address
First Line	:	1812 GATEWAY CIR
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75051-5503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 GATEWAY CIR
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75051-5503
Country	:	US
Telephone Number	:	682-583-1276
Fax Number	:

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

Provider Enumeration Date	:	11/12/2019
Last Update Date	:	08/20/2021

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