Healthcare Provider Details

I. General information

NPI: 1164096780
Provider Name (Legal Business Name): PARAGON PRIMARY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 12/28/2022
Certification Date: 12/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2895 LEWIS LN
PARIS TX
75460-9331
US

IV. Provider business mailing address

PO BOX 1200
COLLEYVILLE TX
76034-1200
US

V. Phone/Fax

Practice location:
  • Phone: 972-203-3600
  • Fax:
Mailing address:
  • Phone: 972-203-3600
  • Fax: 972-203-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN MCNERNEY
Title or Position: PRACTICE ADMINSTRATOR
Credential:
Phone: 145-029-7712