Healthcare Provider Details

I. General information

NPI: 1386614766
Provider Name (Legal Business Name): PARIS FAMILY PHYSICIANS,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 CLARKSVILLE ST STE. 100
PARIS TX
75460-6060
US

IV. Provider business mailing address

1128 CLARKSVILLE ST STE. 100
PARIS TX
75460-6060
US

V. Phone/Fax

Practice location:
  • Phone: 903-669-0800
  • Fax: 903-782-9365
Mailing address:
  • Phone: 903-785-4362
  • Fax: 903-782-9365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURIE BETH RAST
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 903-785-4362