Provider Demographics
NPI:1144349200
Name:SOLOMON, PAUL ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALAN
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4740 HOLLY TREE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7219
Mailing Address - Country:US
Mailing Address - Phone:972-447-9913
Mailing Address - Fax:
Practice Address - Street 1:4740 HOLLY TREE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7219
Practice Address - Country:US
Practice Address - Phone:972-447-9913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7185207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS17636OtherSTATE LICENSE
TXF7185OtherORIGINAL STATE LICENSE
ALMD24716OtherSTATE LICENSE
OK22841OtherSTATE LICENSE
AZ37161OtherSTATE LICENSE
LAMD14585ROtherSTATE LICENSE