Basic Information
| Provider Information | |||||||||
| NPI: | 1730298621 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAREDES | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2102 TREASURE HILLS BLVD # 3.14406 | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562961437 | ||||||||
| FaxNumber: | 9562966842 | ||||||||
| Practice Location | |||||||||
| Address1: | 5423 S MCCOLL RD | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785399183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563623575 | ||||||||
| FaxNumber: | 9563623584 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 10/24/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MB06652600 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | P6885 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | P6885 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3216517-03 | 05 | TX | MEDICAID |