Provider Demographics
NPI:1457655508
Name:PARAGON SURGICAL ASSISTANTS LLC
Entity Type:Organization
Organization Name:PARAGON SURGICAL ASSISTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-536-2313
Mailing Address - Street 1:1314 W MCDERMOTT DR
Mailing Address - Street 2:STE 106-608
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3021
Mailing Address - Country:US
Mailing Address - Phone:214-202-7400
Mailing Address - Fax:
Practice Address - Street 1:1314 W MCDERMOTT DR
Practice Address - Street 2:STE 106-608
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3021
Practice Address - Country:US
Practice Address - Phone:214-202-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Multi-Specialty