Provider Demographics
NPI:1396768594
Name:KINDE, PAUL J (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:KINDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1002W SAM HOUSTON BLVD 4
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5198
Mailing Address - Country:US
Mailing Address - Phone:956-783-1400
Mailing Address - Fax:956-783-8818
Practice Address - Street 1:1000 EXPRESSWAY 83
Practice Address - Street 2:STE 4
Practice Address - City:LA JOYA
Practice Address - State:TX
Practice Address - Zip Code:78560
Practice Address - Country:US
Practice Address - Phone:956-585-1688
Practice Address - Fax:956-585-8008
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6984207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171171501Medicaid
TX8B9951OtherBCBS
TXP00352721OtherRAILROAD
TX8B8394Medicare PIN
TX8B9951OtherBCBS