Provider Demographics
NPI:1699089771
Name:PARVEEN, UNKNOWN (MD)
Entity type:Individual
Prefix:
First Name:UNKNOWN
Middle Name:
Last Name:PARVEEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:PARVEEN
Other - Middle Name:
Other - Last Name:PARVEEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:850 W RIO SALADO PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3812
Mailing Address - Country:US
Mailing Address - Phone:804-808-3304
Mailing Address - Fax:602-393-0293
Practice Address - Street 1:129 VISION PARK BLVD STE 109
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3024
Practice Address - Country:US
Practice Address - Phone:936-273-0836
Practice Address - Fax:936-321-2266
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT196355207R00000X
AZ47761208M00000X
TXS3038207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist