Organization Active NPI

Paul W. Daum, M.D., P.L.L.C.

  • Obstetrics & Gynecology Physician
  • Mansfield, TX
National Provider Identifier
1295205037
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PAUL W. DAUM, M.D., P.L.L.C.
Practice address
2800 E Broad St Ste 412
Mansfield, TX 76063-6414
Phone
(972) 723-1023
NPI assigned
Dec 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Dr. Paul W. Daum, MDNPI 1942212576
Title
Owner
Phone
(817) 477-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

2800 E Broad St Ste 412
Mansfield, TX 76063-6414

Mailing address

2800 E Broad St Ste 412
Mansfield, TX 76063-6414
Phone (972) 723-1023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190212001170 TX Part B Supplier - Clinic/Group Practice 8426396706 Receives reassigned benefits from 1 practitioner
Practice locations: Mansfield, TX

National Provider Directory

National Provider Directory

Locations

2800 E Broad St
Ste 412
Mansfield, TX 76063
Phone (817) 477-0200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1295205037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST STE 412",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636414",
            "telephone_number": "972-723-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST STE 412",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636414",
            "telephone_number": "972-723-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL W. DAUM, M.D., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-04",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "DAUM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-477-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.