Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME93500 | FL |
N | 207V00000X | Obstetrician & Gynecologist | N2629 | TX |
Y | 207VX0201X | Gynecologic Oncologist | N2629 | TX |
NPI | 1063488617 |
---|---|
Provider Name | Dr. Paul Loar III |
First Address | Dallas, TX 75391-1230 |
Second Address | Austin, TX 78705-1163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 07/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063488617 | BCBS TX (01) | TX |
204072701 | (05) | TX |
204072702 | (05) | TX |
204072703 | (05) | TX |
I37880 | (02) | FL |
P00784608 | RAILROAD MEDICARE (01) | TX |