Healthcare Provider Details

I. General information

NPI: 1043514383
Provider Name (Legal Business Name): PARADOX HEALTHCARE SYSTEMS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2010
Last Update Date: 12/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 WALNUT ST
BOWIE TX
76230-4840
US

IV. Provider business mailing address

207 WALNUT ST
BOWIE TX
76230-4840
US

V. Phone/Fax

Practice location:
  • Phone: 940-872-6301
  • Fax: 940-872-6015
Mailing address:
  • Phone: 940-872-6301
  • Fax: 940-872-6015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC6307
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC6021
License Number StateTX

VIII. Authorized Official

Name: DR. DIRAN A. LANCASTER
Title or Position: PRESIDENT
Credential: DC
Phone: 940-872-6301