Provider Demographics
NPI:1710296280
Name:PARADIGM AMBULATORY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PARADIGM AMBULATORY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WON
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:888-559-2666
Mailing Address - Street 1:8409 PICKWICK LN # 264
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5323
Mailing Address - Country:US
Mailing Address - Phone:903-450-8704
Mailing Address - Fax:903-450-8997
Practice Address - Street 1:8409 PICKWICK LN # 264
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5323
Practice Address - Country:US
Practice Address - Phone:903-450-8704
Practice Address - Fax:903-450-8997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty