Provider Demographics
NPI:1548292600
Name:NOLAN, PAUL KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:KEITH
Last Name:NOLAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3533 SOUTH ALAMEDA - 5TH FLOOR SLOAN BLDG.
Mailing Address - Street 2:PEDIATRIC PULMONOLOGY DEPT-DRISCOLL CHILDREN'S HOSPITAL
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411
Mailing Address - Country:US
Mailing Address - Phone:361-694-6128
Mailing Address - Fax:361-694-4179
Practice Address - Street 1:3533 SOUTH ALAMEDA - 5TH FLOOR SLOAN BLDG.
Practice Address - Street 2:PEDIATRIC PULMONOLOGY DEPT-DRISCOLL CHILDREN'S HOSPITAL
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-694-6128
Practice Address - Fax:361-694-4179
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH26462080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139331622Medicaid
TX139331622Medicaid
TXTXB125828Medicare PIN