Healthcare Provider Details

I. General information

NPI: 1962646455
Provider Name (Legal Business Name): PARADIGM HEALTHCARE ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 08/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W BELT LINE RD SUITE C400
CEDAR HILL TX
75104-2060
US

IV. Provider business mailing address

PO BOX 183070
ARLINGTON TX
76096-3070
US

V. Phone/Fax

Practice location:
  • Phone: 877-776-7219
  • Fax: 877-776-7209
Mailing address:
  • Phone: 877-776-7219
  • Fax: 877-776-7209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK9595
License Number StateTX

VIII. Authorized Official

Name: MS. NICOLE E. TRIBBLE
Title or Position: COO
Credential: PA-C
Phone: 214-682-3095