MEDICARE: CITY OF CEDAR PARK

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
1	146L00000X	Paramedic	246012	TX

General Provider Information

NPI Number	:	1780710731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF CEDAR PARK

Provider Business Mailing Address
First Line	:	PO BOX 691363
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77269-1363
Country	:	US
Telephone Number	:	281-397-0397
Fax Number	:	281-397-6934

Provider Business Practice Location Address
First Line	:	450 CYPRESS CREEK RD
Second Line	:	BUILDING 3
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-4194
Country	:	US
Telephone Number	:	512-401-5220
Fax Number	:	512-260-2464

Authorized Official
Title or Position	:	ACCOUNT REPRESENTATIVE
Name	:	KAREN P LAAKE
Credential	:
Telephone Number	:	281-397-0397

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	02/09/2015

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1275283335 — DR. MANAN PARESH SHETH MD
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Directions to “CITY OF CEDAR PARK ” Practice Location

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