Individual
PAUL M SOUTHERN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 648-1620
(214) 648-4080
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 648-1620
(214) 648-4080
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
C7780
TX
207ZM0300X
Medical Microbiology Physician
C7780
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125187802
—
TX
Enumeration date
04/05/2006
Last updated
12/18/2007
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