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1275724981
PAULINA PURNAMA
SOUTHLAKE, TX
NPI
1275724981
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: TX PA11021)
Enumeration Date
2007-08-07
Last Update Date
2022-07-21
Business Address
-- PAULINA PURNAMA PA-C
2600 E SOUTHLAKE BLVD STE 120-177
SOUTHLAKE, TX 76092-6634
Phone number: 469-708-3989
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Mailing Address
-- PAULINA PURNAMA PA-C
2600 E SOUTHLAKE BLVD STE 120-177
SOUTHLAKE, TX 76092-6634
Phone number: 469-708-3989
Copy
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