Paul Wade Bauer, MD
Individual provider Active NPI Pediatric Otolaryngology Physician · Coppell, TX
NPI 1942265285 · NPPES record last updated Jul 8, 2013
Key facts
- NPI
- 1942265285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Otolaryngology Physician 207YP0228X
- License
- L3574 (TX)
- Practice address
- 783 N. Denton Tap Rd
Ste 200
Coppell, TX 75019 - Phone
- (972) 745-8400
- Fax
- (972) 315-9011
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L3574 | TX | MD | Pediatric Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ENT for Children, P.a. | Pediatric Otolaryngology | Past | Accepting new patients |
| Frisco ENT for Children, P.L.L.C. | Pediatric Otolaryngology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Otolaryngology Physician | 207YP0228X | L3574 | TX | Yes |
Addresses
Primary practice location
783 N. Denton Tap Rd
Ste 200
Coppell, TX 75019
Mailing address
783 N. Denton Tap Rd.
Suite 200
Coppell, TX 75019
Phone (972) 745-8400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 152662603 | Medicaid | TX |
Other providers in Coppell, TX
- Anafernanda Barrera
- Meagan Elizabeth Barrera
- Julia Bartholow
- Russell King Bass
- Taylor Bateman
- Emily Baumann
- Laura Baxa
- Douglas E Bedichek
- Michelle Beia
- Belfrom Psychological Services, PLLC
All providers in Coppell, TX · Pediatric Otolaryngology 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 Jul 8, 2013. 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.