1881730703 NPI number — PARAGON ANESTHESIA ASSOCIATES, P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881730703 NPI number — PARAGON ANESTHESIA ASSOCIATES, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARAGON ANESTHESIA ASSOCIATES, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881730703
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7232 GLENDORA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75230-5430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-891-0501
Provider Business Mailing Address Fax Number:
214-987-0897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10455 N CENTRAL EXPY
Provider Second Line Business Practice Location Address:
109-339
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-2213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-891-0501
Provider Business Practice Location Address Fax Number:
214-987-0897
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FISHER
Authorized Official First Name:
NEAL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWBER
Authorized Official Telephone Number:
214-890-0501

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  H2375 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com