Provider Demographics
NPI:1962550608
Name:PARAGON INFUSION CARE INC
Entity type:Organization
Organization Name:PARAGON INFUSION CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULDERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-588-1000
Mailing Address - Street 1:3033 W PRESIDENT GEORGE BUSH HWY STE 100-A
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-5752
Mailing Address - Country:US
Mailing Address - Phone:972-588-1000
Mailing Address - Fax:972-588-1001
Practice Address - Street 1:3033 W PRESIDENT GEORGE BUSH HWY STE 100-A
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-5752
Practice Address - Country:US
Practice Address - Phone:972-588-1000
Practice Address - Fax:972-588-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22975251F00000X, 332B00000X, 3336H0001X, 3336S0011X
332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX750809OtherBCBS TX
TX=========OtherTRICARE MILITARY
TX=========OtherTRICARE MILITARY