Provider Demographics
NPI:1386804326
Name:IBRAHIM, PARISA (MD)
Entity type:Individual
Prefix:DR
First Name:PARISA
Middle Name:
Last Name:IBRAHIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:631 N RESLER DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2382
Mailing Address - Country:US
Mailing Address - Phone:915-842-0676
Mailing Address - Fax:915-842-0738
Practice Address - Street 1:631 N RESLER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-2382
Practice Address - Country:US
Practice Address - Phone:915-842-0676
Practice Address - Fax:915-842-0676
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01069413A207R00000X
TXP2681207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN91969413AOtherLICENSE
TXP2681OtherLICENSE