Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | F6061 | TX |
NPI | 1366483414 |
---|---|
Provider Name | Dr. Paul D Pace |
First Address | San Antonio, TX 78216-6905 |
Second Address | San Antonio, TX 78216-6905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 23/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2853151 | CIGNA (01) | TX |
4059402 | AETNA (01) | TX |
8B8401 | BCBS (01) | TX |
C20113 | (02) | TX |