Paul Taylor Anderson, MAT, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT7859 Issued in TX

Practice address

11672 Stockmeyer Dr
El Paso, TX 79936-0813

Phone

(915) 252-3211

NPI assigned

Jan 24, 2019

Last updated

Jan 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1184188146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11672 STOCKMEYER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799360813",
            "telephone_number": "915-252-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11672 STOCKMEYER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799360813",
            "telephone_number": "915-252-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PAUL",
        "middle_name": "TAYLOR",
        "credential": "MAT, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-24",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT7859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Alice Anderson, MD, MPH
• Masse Anderson
• Nancy Geraldine Anderson, LMSW
• Nathaniel Anderson
• Nicole Anderson, MS CCC-SLP
• Sarah Anderson
• Wendy Anderson
• Nilsa Grisel Andino, PT
• Wilfredo Andino, PTA
• Jose G Andrade-Barraza, MD

• Athletic Trainer in El Paso, TX
• Providers in El Paso, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.