Provider Demographics
NPI:1023596590
Name:PARAMOUNT PRINCE REHABILITATION, LP
Entity type:Organization
Organization Name:PARAMOUNT PRINCE REHABILITATION, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MBA
Authorized Official - Phone:214-325-1462
Mailing Address - Street 1:105 N TRENTON ST
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-4321
Mailing Address - Country:US
Mailing Address - Phone:318-255-1514
Mailing Address - Fax:
Practice Address - Street 1:11855 LEBANON RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-8225
Practice Address - Country:US
Practice Address - Phone:469-269-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation