Provider Demographics
NPI:1538760590
Name:PARADA, THERESA VANNOY (COMS)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:VANNOY
Last Name:PARADA
Suffix:
Gender:F
Credentials:COMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12904 HARRISBURG CIR
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-6222
Mailing Address - Country:US
Mailing Address - Phone:972-896-9642
Mailing Address - Fax:
Practice Address - Street 1:13310 BEE ST
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-6117
Practice Address - Country:US
Practice Address - Phone:972-896-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174400000XOther Service ProvidersSpecialist