Healthcare Provider Details

I. General information

NPI: 1780958777
Provider Name (Legal Business Name): PARAGON PAIN & REHABILITATION LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 10/18/2023
Certification Date: 10/17/2023
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:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN FRANCES MCNERNEY
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 972-203-3600