Paul Wesolow MD
Organization Active NPI Family Medicine Physician · Sour Lake, TX
NPI 1407977960 · NPPES record last updated Mar 6, 2008
Key facts
- NPI
- 1407977960
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- J1812 (TX)
- Legal business name
- PAUL WESOLOW MD
- Practice address
- 517 S Hwy 326
Sour Lake, TX 77659 - Phone
- (409) 287-2762
- NPI assigned
- Apr 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Paul Wesolow, MD
- Title
- Paul Wesolow MD
- Phone
- (409) 287-2762
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | J1812 | TX | Yes |
Addresses
Primary practice location
517 S Hwy 326
Sour Lake, TX 77659
Mailing address
PO Box 949
Sour Lake, TX 77659
Phone (409) 287-2762
Other names
- Sour Lake Family Medical
Other providers in Sour Lake, TX
- Patricia Ann Heirtzler
- Karla Michelle Kicak
- Shawn D Klinger
- Lauren Letsinger
- Kristine Matlock
- Thomas C Perry
- Ciera Brooke Reeves
- John H Shary III
- Sour Lake Health & Medical, PLLC
- James Eric Weldon
All providers in Sour Lake, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.