Basic Information
| Provider Information | |||||||||
| NPI: | 1215158092 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESPY | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | GOODMAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 848491 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752848491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542029330 | ||||||||
| FaxNumber: | 2542029349 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 HILLCREST MEDICAL BLVD STE 102 | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767128953 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542027900 | ||||||||
| FaxNumber: | 2542027949 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 09/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 059150 | GA | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | R4218 | TX | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.