Individual
PAUL A OVERLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3514 21ST ST, LUBBOCK, TX 79410-1210
(806) 725-1801
(806) 723-7535
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
H5345
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000W7173
—
NM
05
—
119000106
—
TX
01
—
120843107
FIRSTCARE
TX
01
—
274410YKT8
MEDICARE
TX
01
—
8GH487
BCBS TX
TX
01
—
P01772077
RAILROAD MEDICARE
TX
Enumeration date
06/09/2005
Last updated
12/07/2017
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