Individual provider Active NPI

Paul David Walter, MD

  • Cardiovascular Disease Physician
  • Lubbock, TX
National Provider Identifier
1629031307
Registry record updated Jul 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
F5088 Issued in TX
Practice address
3514 21St St
Lubbock, TX 79410-1210
Phone
(806) 725-1801
Fax
(806) 723-7530
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X F5088 TX Primary
Cardiovascular Disease Physician 207RC0000X 85117 NM

Addresses

Primary practice location

3514 21St St
Lubbock, TX 79410-1210

Mailing address

3420 22ND PL
Lubbock, TX 79410-1314
Phone (806) 725-7800

Other identifiers 1

IdentifierTypeStateIssuer
105356303MedicaidTX

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
I20031106000369 TX Practitioner - Cardiovascular Disease (Cardiology) 8628981610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Harvard Medical School, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

3514 21St St
Lubbock, TX 79410-1210
Phone (806) 792-5105

3601 21St St
Lubbock, TX 79410-1229
Phone (806) 791-0399

3710 21St St
Lubbock, TX 79410-1220
Phone (806) 780-8003

4015 22ND PL
Lubbock, TX 79410-1119
Phone (806) 725-0015

9812 Slide Rd
Lubbock, TX 79424-5781
Phone (806) 725-8400

Hospital & facility affiliations

  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040
  • Covenant Childrens Hospital Hospital, Lubbock, TX, CCN 453306
  • Roosevelt General Hospital Hospital, Portales, NM, CCN 320084
  • Grace Surgical Hospital Hospital, Lubbock, TX, CCN 450162
  • Covenant Hospital Plainview Hospital, Plainview, TX, CCN 450539

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85117NMMDCardiovascular Disease Physician
F5088TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince Nov 1, 2002 Accepting new patients
Covenant Medical Center CurrentSince Jul 20, 2020 Accepting new patients
Covenant Medical Group CurrentSince Nov 1, 2002 Accepting new patients
Roosevelt County Special Hospital District Cardiovascular Disease Past Accepting new patients

Locations

2000 W 21st St
Ste W7
Clovis, NM 88101
Phone (575) 637-7000

1600 N Main Ave
Lovington, NM 88260
Phone (575) 396-6611

42121 US Highway 70
Portales, NM 88130
Phone (505) 226-3627

3420 22nd Pl
Lubbock, TX 79410
Phone (806) 725-1800

7601 Quaker Ave
Lubbock, TX 79424
Phone (806) 725-9444

3514 21st St
Lubbock, TX 79410
Phone (806) 725-1801

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

3615 19th St
Lubbock, TX 79410
Phone (806) 725-0000

Interoperability endpoints

  • Direct secure messaging: pwalter1930200@oc.providencedirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248048000000",
    "number": "1629031307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101314",
            "telephone_number": "806-725-7800",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 21ST ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101210",
            "telephone_number": "806-725-1801",
            "fax_number": "806-723-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2009-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "F5088",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NM",
            "license": "85117",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105356303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.