Provider Demographics
NPI:1497017149
Name:PENA, PAUL PIEZAS (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:PIEZAS
Last Name:PENA
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 1:10787 NALL AVE STE 310
Mailing Address - Street 2:MEDICAL PLAZA INTERNAL MEDICINE
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1301
Mailing Address - Country:US
Mailing Address - Phone:913-945-6900
Mailing Address - Fax:
Practice Address - Street 1:10787 NALL AVE STE 310
Practice Address - Street 2:MEDICAL PLAZA INTERNAL MEDICINE
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1301
Practice Address - Country:US
Practice Address - Phone:913-945-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0438204207R00000X
KS9407909207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine