Walter Stephen Pavlic, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

583938 Issued in TX

Practice address

755 S Beckham Ave
Tyler, TX 75701-1903

Phone

(903) 532-1400

NPI assigned

May 24, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1255822250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CROSS TIMBERS ST",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759047586",
            "telephone_number": "936-465-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011903",
            "telephone_number": "903-532-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLIC",
        "first_name": "WALTER",
        "middle_name": "STEPHEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "583938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrington Paul
• Kevin R Paul, MD
• Stephanie Pauley
• Darlene Paulson
• Mindy Paulson
• Amy Payne
• Cynthia Payne
• Karson Payne
• Robert M Payne, MD
• Sophie N Payne

• Home Health Registered Nurse in Tyler, TX
• Providers in Tyler, TX by specialty
• Home Health Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.