Provider Demographics
NPI:1205506342
Name:PAREDES, AILA SALAZAR (APN)
Entity type:Individual
Prefix:
First Name:AILA
Middle Name:SALAZAR
Last Name:PAREDES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 S CONGRESS AVE STE C200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3601 S CONGRESS AVE STE C200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7299
Practice Address - Country:US
Practice Address - Phone:512-537-4087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10014029363LF0000X
NJ26NJ01142300363LF0000X
AZ294678363LF0000X
NV868162363LF0000X
WAAP61455155363LF0000X
CA95022846363LF0000X
TX1031273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily