PAULINA PURNAMA (NPI# 1275724981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275724981 |
| Entity Type | Individual |
| Full Name | PAULINA PURNAMA |
| Credential | PA-C |
| Practice Address |
2600 E Southlake Blvd Ste 120-177 Southlake TX 76092-6634 |
| Practice Telephone | (469) 708-3989 |
| Mailing Telephone | (469) 708-3989 |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2017-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA11021 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2600 E SOUTHLAKE BLVD STE 120-177 |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092-6634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346767431 | Elite Pa Surgical Assists, Pllc | Orthopaedic Surgery | 2600 E Southlake Blvd Ste 120-177, Southlake, TX 76092-6634 | 2017-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518438977 | Sbs Provider Services, L.L.C. | Physician Assistant | 1440 Eagle Bnd, Southlake, TX 76092-9426 | 2018-12-11 |
| 1376013383 | Dfw Surgical Assist, LLC | Physician Assistant | 1406 Laurel Ln, Southlake, TX 76092-3573 | 2018-12-03 |
| 1114451614 | Squire Surgical Services Pllc | Physician Assistant | 2004 Vail Rd, Southlake, TX 76092-3849 | 2017-04-12 |
| 1073968392 | Gmc Medical, Pllc | Physician Assistant | 950 E State Highway 114 Ste 160, Southlake, TX 76092-5261 | 2016-04-25 |
| 1073929576 | Specialty Surgical Services Pllc | Physician Assistant | 910 E Southlake Blvd, 155, Southlake, TX 76092-6388 | 2014-07-03 |
| 1750385456 | Stefanie N Sanderson | Physician Assistant | 1545 E Southlake Blvd, Suite 100, Southlake, TX 76092-6422 | 2005-06-09 |
| 1720092091 | Patrick Clay Buzbee | Physician Assistant | 1545 E Southlake Blvd, Suite 100, Southlake, TX 76092 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133340 | Mark Alan Williams | Physician Assistant | 4814 Lake Livingston Dr, Corpus Christi, TX 78413-5139 | 2020-10-28 |
| 1669081238 | Manuel V Leyva | Physician Assistant | 8407 Sunset Loch Dr, Spring, TX 77379-5121 | 2020-07-29 |
| 1194342212 | Sean Robert Jamieson | Physician Assistant | 2700 E Broad St Ste 200, Mansfield, TX 76063-5899 | 2020-07-06 |
| 1588284194 | Hill Country Surgical Management, Inc | Physician Assistant | 10454 Tippecanoe, San Antonio, TX 78245-3128 | 2020-04-23 |
| 1407475585 | Serenity Surgical Services | Physician Assistant | 3260 Springbok Cir, Frisco, TX 75034-3671 | 2020-04-09 |
| 1720610470 | Surgical Assistants of South Texas | Physician Assistant | 3414 Highway 146 S, La Porte, TX 77571-7400 | 2020-02-11 |
| 1710524103 | R & H Surgical Services, LLC | Physician Assistant | 14507 Parkesgate Dr, Houston, TX 77083-5792 | 2019-12-04 |
| 1639711195 | Landry & Kiejna Surgical Assisting | Physician Assistant | 1120 Business Center Dr Ste 110, Houston, TX 77043-2735 | 2019-10-16 |
| 1912558693 | Chandrant Akshar Pa | Physician Assistant | 400 W Arbrook Blvd Ste 230, Arlington, TX 76014-3174 | 2019-09-24 |
| 1700435831 | Christina A Vogel-rosbrook | Physician Assistant | 4330 Medical Drive, Suite 120, San Antonio, TX 78229-3353 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PAULINA PURNAMA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.