Basic Information
| Provider Information | |||||||||
| NPI: | 1336467224 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WAHL | ||||||||
| FirstName: | PAIGE | ||||||||
| MiddleName: | BAILEY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU,D, | ||||||||
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| Mailing Information | |||||||||
| Address1: | UTSW OTOLARYNGOLOGY HEAD & NECK SURGERY | ||||||||
| Address2: | 5323 HARRY HINES BLVD | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753900001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | UTSW OTOLARYNGOLOGY HEAD & NECK SURGERY | ||||||||
| Address2: | 5323 HARRY HINES BLVD | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753900001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146458898 | ||||||||
| FaxNumber: | 2146458894 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2010 | ||||||||
| LastUpdateDate: | 05/17/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 80214 | TX | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.