Individual
PAUL TAGASHIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-4376
Mailing address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-4376
(210) 292-2052
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1439
NV
363AM0700X
Medical Physician Assistant
Primary
54382
CA
363AM0700X
Medical Physician Assistant
PA13827
TX
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780985457
—
NV
Enumeration date
11/10/2010
Last updated
09/02/2021
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