Healthcare Provider Details

I. General information

NPI: 1932530904
Provider Name (Legal Business Name): JOSHUA CHRISTOPHER PAREDES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2013
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11816 INWOOD RD # 3090
DALLAS TX
75244-8011
US

IV. Provider business mailing address

11816 INWOOD RD # 3090
DALLAS TX
75244-8011
US

V. Phone/Fax

Practice location:
  • Phone: 918-210-4961
  • Fax:
Mailing address:
  • Phone: 918-210-4961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR000111696
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR000111696
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR000111696
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR000111696
License Number StateOK
# 5
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number898926
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: