Provider Demographics
NPI:1740835602
Name:PAREDES, ANDRES ALEJANDRO (PA)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:ALEJANDRO
Last Name:PAREDES
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:220 FALCON PKWY
Mailing Address - Street 2:
Mailing Address - City:SCHRIEVER AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80912-5005
Mailing Address - Country:US
Mailing Address - Phone:719-524-2273
Mailing Address - Fax:
Practice Address - Street 1:559 VINCENT ST SPC BASE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80914-1541
Practice Address - Country:US
Practice Address - Phone:719-524-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-07
Last Update Date:2024-06-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant