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Individual

PAUL A REDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
34910 INTERSTATE 10 W, BOERNE, TX 78006-9229
(361) 994-4880
(361) 994-4890
Mailing address
1620 N MAIN ST, SPANISH FORK, UT 84660-1008
(801) 822-2234

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
101249
WI
207Y00000X
Otolaryngology Physician
Primary
J7153
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100262986
WI
05
1353229-12
TX
05
135322913
TX
05
135322914
TX
05
135322916
TX
01
8BR082
BCBS
TX
01
8S4592
BCBS
TX
Enumeration date
06/29/2006
Last updated
08/14/2024
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