Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | R6073 | TX |
Y | 111NI0900X | Internist | R6073 | TX |
NPI | 1003229147 |
---|---|
Provider Name | Dr. James Harold Pavela |
First Address | Galveston, TX 77555-0570 |
Second Address | Galveston, TX 77555-0570 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2014 |
Last Update Date | 17/06/2021 |