Individual
GARY DANIEL PARADISO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
855 MONTGOMERY, FORT WORTH, TX 76107-2553
(817) 927-4100
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F9919
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130319007
—
TX
01
—
8EW674
BCBS
TX
01
—
P01488175
RAILROAD MEDICARE
TX
Enumeration date
09/12/2006
Last updated
09/16/2015
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