Provider Demographics
NPI:1164825451
Name:PARADIGM CONSULTING
Entity Type:Organization
Organization Name:PARADIGM CONSULTING
Other - Org Name:MOBILEADVENTURES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN; CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-602-8423
Mailing Address - Street 1:3201 FANNIN LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-3329
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3201 FANNIN LN
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-3329
Practice Address - Country:US
Practice Address - Phone:817-602-8423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty