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General NPI Number Information
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NPI Number | 1871019828
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Entity Type | Organization
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Legal Business Name | PARIS LAKES HEALTH GROUP INC
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 03/06/2019
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Provider Practice Location Address
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Address Line | 2675 41ST ST SE STE 102
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City | PARIS
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State | TX
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Zip | 75462-8209
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Country | US
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Telephone | 903-739-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 9475 BRIAR VILLAGE PT STE 220
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7908
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LAURA WILLIAMS
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Credential |
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Telephone | 903-609-1065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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