Individual
PAIGE LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H9534
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103996804
—
TX
05
—
103996805
—
TX
05
—
103996806
—
TX
05
—
103996807
—
TX
05
—
103996808
—
TX
01
—
8EH524
BCBS TX
TX
01
—
8X1972
BCBS
TX
01
—
P00648348
RAILROAD
TX
Enumeration date
06/03/2006
Last updated
10/29/2015
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