Provider Demographics
NPI:1992839799
Name:PARAMOUNT CARDIOVASCULAR ASSOCIATES
Entity Type:Organization
Organization Name:PARAMOUNT CARDIOVASCULAR ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-591-6009
Mailing Address - Street 1:2601 SCRIPTURE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-4322
Mailing Address - Country:US
Mailing Address - Phone:940-591-6009
Mailing Address - Fax:940-591-9918
Practice Address - Street 1:2601 SCRIPTURE ST STE 101
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4322
Practice Address - Country:US
Practice Address - Phone:940-591-6009
Practice Address - Fax:940-591-9918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4353207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3451394OtherCIGNA
89410YOtherBCBS
TX109400501Medicaid
2293174OtherAETNA
89410YOtherBCBS