Provider Demographics
NPI:1164096780
Name:PARAGON PRIMARY CARE PLLC
Entity Type:Organization
Organization Name:PARAGON PRIMARY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:145-029-7712
Mailing Address - Street 1:PO BOX 1200
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-1200
Mailing Address - Country:US
Mailing Address - Phone:972-203-3600
Mailing Address - Fax:972-203-3601
Practice Address - Street 1:2895 LEWIS LN
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-9331
Practice Address - Country:US
Practice Address - Phone:972-203-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty