Provider Demographics
NPI:1194572321
Name:PAKRAVAN, PARASTOU
Entity type:Individual
Prefix:
First Name:PARASTOU
Middle Name:
Last Name:PAKRAVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 COURSE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7403
Mailing Address - Country:US
Mailing Address - Phone:310-210-8247
Mailing Address - Fax:
Practice Address - Street 1:6400 FANNIN ST FL 18
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:713-486-9400
Practice Address - Fax:713-486-9592
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program