Provider Demographics
NPI:1174978738
Name:TRAMMELL, PAUL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:TRAMMELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 4TH ST
Mailing Address - Street 2:APT #C029
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79415-3233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3002 4TH ST
Practice Address - Street 2:APT C029
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3233
Practice Address - Country:US
Practice Address - Phone:432-631-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program