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General NPI Number Information
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NPI Number | 1508541384
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Entity Type | Organization
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Legal Business Name | PARADISE MEDICAL MANAGEMENT LLC
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 13020 DAIRY ASHFORD RD STE 301
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City | SUGAR LAND
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State | TX
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Zip | 77478-4663
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Country | US
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Telephone | 713-732-2730
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Fax |
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Provider Business Mailing Address
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Address Line | 77 SUGAR CREEK CENTER BLVD STE 600
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City | SUGAR LAND
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State | TX
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Zip | 77478-3688
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Country | US
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Telephone | 832-990-6729
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. ISRAA MAHDI
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Credential |
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Telephone | 713-732-2730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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