Individual
DR. BRENT R. PAULGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2202 ITHACA AVE, LUBBOCK, TX 79410-1332
(806) 797-1202
(806) 797-4854
Mailing address
2202 ITHACA AVE, LUBBOCK, TX 79410-1332
(806) 797-1202
(806) 797-4854
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
J6653
TX
207ND0101X
MOHS-Micrographic Surgery Physician
J6653
TX
207ND0900X
Dermatopathology Physician
J6653
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070014509
HMO BLUE
TX
01
—
121179100
FIRST CARE
TX
01
—
8412K0
BCBS TEXAS
TX
01
—
NM004352
BCBS NEW MEXICO
NM
Enumeration date
09/21/2005
Last updated
05/22/2020
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