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NPI Code Detail

MEDICARE: BRENDA J PARIS MD

MEDICARE: BRENDA J PARIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianDR.0058373CO
22085R0202XDiagnostic Radiology PhysicianH4958TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
285960ROTHERTXMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538105580
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA J PARIS MD
Provider Business Mailing Address
First Line : PO BOX 1888
Second Line :
City : GREENVILLE
State : TX
Zip : 75403-1888
Country : US
Telephone Number : 800-593-3216
Fax Number : 903-453-2525
Provider Business Practice Location Address
First Line : 3333 N FOSTER MALDONADO BLVD
Second Line :
City : EAGLE PASS
State : TX
Zip : 78852-5893
Country : US
Telephone Number : 830-773-5321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 07/21/2022

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