Donald R Paek Sr., MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

GA188 Issued in TX

Practice address

5701 Bryant Irvin Rd
Suite 102
Fort Worth, TX 76132-4029

Phone

(817) 294-4184

Fax

(817) 294-4198

NPI assigned

Jul 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1902806482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD",
            "address_2": "SUITE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324029",
            "telephone_number": "817-294-4184",
            "fax_number": "817-294-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD",
            "address_2": "SUITE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324029",
            "telephone_number": "817-294-4184",
            "fax_number": "817-294-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAEK",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "GA188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Padilla
• Audrey Padilla
• Gabriela Ana Padilla, LPC
• Melissa Padilla, LMSW
• Amrutha Padmasolala, LMSW
• Pafford Medical Services Corporation of Texas, Inc
• Ian Keith Pagdilao, LPC, NCC
• Delaney Elizabeth Page
• Derek Layne Page Sr., D.C.
• Elijah Page

• Dermatology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.