Individual provider Active NPI

Paul Bruce Covell, D.D.S.

  • General Practice Dentistry
  • Pasadena, TX
National Provider Identifier
1124174255
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11065 Issued in TX
Practice address
4010 Vista Rd
Suite D
Pasadena, TX 77504-2140
Phone
(713) 943-9832
Fax
(713) 943-1912
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11065 TX Primary

Addresses

Primary practice location

4010 Vista Rd
Suite D
Pasadena, TX 77504-2140

Mailing address

4010 Vista Rd
Suite D
Pasadena, TX 77504-2140
Phone (713) 943-9832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171106002966 TX Order and Referring Only - DentistPractitioner - Dentist 5890051916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1124174255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 VISTA RD",
            "address_2": "SUITE D",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775042140",
            "telephone_number": "713-943-9832",
            "fax_number": "713-943-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 VISTA RD",
            "address_2": "SUITE D",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775042140",
            "telephone_number": "713-943-9832",
            "fax_number": "713-943-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVELL",
        "first_name": "PAUL",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "11065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.