Individual provider Active NPI

Paul Arthur Tobolowsky, M.D.

  • Internal Medicine Physician
  • Plano, TX
National Provider Identifier
1366558876
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
F5070 Issued in TX
Practice address
4708 Alliance Blvd Ste 300
Baylor Medical Plaza 1
Plano, TX 75093-5339
Phone
(972) 758-6000
Fax
(972) 758-6001
NPI assigned
Aug 21, 2006
Last updated
Jul 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X F5070 TX Primary

Addresses

Primary practice location

4708 Alliance Blvd Ste 300
Baylor Medical Plaza 1
Plano, TX 75093-5339

Mailing address

4708 Alliance Blvd Ste 300
Baylor Medical Plaza 1
Plano, TX 75093-5339
Phone (972) 758-6000

Other identifiers 1

IdentifierTypeStateIssuer
83X018OtherTXBCBS

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160222001054 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4385615616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1366558876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 ALLIANCE BLVD STE 300",
            "address_2": "BAYLOR MEDICAL PLAZA 1",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935339",
            "telephone_number": "972-758-6000",
            "fax_number": "972-758-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 ALLIANCE BLVD STE 300",
            "address_2": "BAYLOR MEDICAL PLAZA 1",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935339",
            "telephone_number": "972-758-6000",
            "fax_number": "972-758-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBOLOWSKY",
        "first_name": "PAUL",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "F5070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "83X018",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.