Provider Demographics
NPI:1356218994
Name:PAREDES, CONNIE FRANCES
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:FRANCES
Last Name:PAREDES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 RUTH ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-2111
Mailing Address - Country:US
Mailing Address - Phone:469-279-3991
Mailing Address - Fax:
Practice Address - Street 1:815 GREENVIEW DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-2439
Practice Address - Country:US
Practice Address - Phone:469-251-1734
Practice Address - Fax:214-778-1251
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT135997225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist