Paragon Plastic Surgery & Med Spa LLC.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

N2005 Issued in TX

Legal business name

PARAGON PLASTIC SURGERY & MED SPA LLC.

Practice address

1101 Matlock Rd
Mansfield, TX 76063-3442

Phone

(817) 473-2120

Fax

(817) 887-5233

NPI assigned

Jul 7, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Bishara, M.D.

Title

Owner

Phone

(817) 473-2120

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1578979902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MATLOCK RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633442",
            "telephone_number": "817-473-2120",
            "fax_number": "817-887-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MATLOCK RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633442",
            "telephone_number": "817-473-2120",
            "fax_number": "817-887-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON PLASTIC SURGERY & MED SPA LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "BISHARA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-473-2120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "N2005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.