Individual
PAUL KENNETH ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4708 ALLIANCE BLVD STE 300, BAYLOR MEDICAL PLAZA 1, PLANO, TX 75093-5339
(972) 758-6000
(972) 758-6001
Mailing address
4708 ALLIANCE BLVD STE 300, BAYLOR MEDICAL PLAZA 1, PLANO, TX 75093-5339
(972) 758-6000
(972) 758-6001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
F4740
TX
207RG0100X
Gastroenterology Physician
Primary
F4740
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1237331-05
—
TX
05
—
123733102
—
TX
Enumeration date
08/16/2006
Last updated
07/28/2009
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