Provider Demographics
NPI:1962646455
Name:PARADIGM HEALTHCARE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:PARADIGM HEALTHCARE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TRIBBLE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:214-682-3095
Mailing Address - Street 1:PO BOX 183070
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76096-3070
Mailing Address - Country:US
Mailing Address - Phone:877-776-7219
Mailing Address - Fax:877-776-7209
Practice Address - Street 1:201 W BELT LINE RD
Practice Address - Street 2:SUITE C400
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2060
Practice Address - Country:US
Practice Address - Phone:877-776-7219
Practice Address - Fax:877-776-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9595207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A4014Medicare PIN