Paul Wesolow MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J1812 Issued in 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

Last updated

Mar 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Wesolow, MD

Title

Paul Wesolow MD

Phone

(409) 287-2762

Specialties & licenses 1

Addresses

Other names 1

• Sour Lake Family Medical Other name

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1407977960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "SOUR LAKE",
            "state": "TX",
            "postal_code": "77659",
            "telephone_number": "409-287-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 S HWY 326",
            "city": "SOUR LAKE",
            "state": "TX",
            "postal_code": "77659",
            "telephone_number": "409-287-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL WESOLOW MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "WESOLOW",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PAUL WESOLOW MD",
        "authorized_official_telephone_number": "409-287-2762",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J1812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sour Lake Family Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patricia Ann Heirtzler, FNP-C
• Karla Michelle Kicak, M.S., CCC-SLP
• Shawn D Klinger, A.T.C, L.A.T
• Lauren Letsinger
• Kristine Matlock
• Thomas C Perry, M.D.
• Ciera Brooke Reeves, MS, LMFTA
• John H Shary III, MD
• Sour Lake Health & Medical, PLLC (Sour Lake Health & Medical)
• James Eric Weldon, M.D.

• Family Medicine Physician in Sour Lake, TX
• Providers in Sour Lake, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.