Provider Demographics
NPI: | 1225034150 |
---|---|
Name: | PARIMOO, RAHUL (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | RAHUL |
Middle Name: | |
Last Name: | PARIMOO |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 708817 |
Mailing Address - Street 2: | |
Mailing Address - City: | SANDY |
Mailing Address - State: | UT |
Mailing Address - Zip Code: | 84070-8817 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 866-869-2395 |
Mailing Address - Fax: | 801-352-7976 |
Practice Address - Street 1: | 414 NAVARRO ST |
Practice Address - Street 2: | SUITE 1405 |
Practice Address - City: | SAN ANTONIO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78205-2516 |
Practice Address - Country: | US |
Practice Address - Phone: | 210-579-3036 |
Practice Address - Fax: | 210-587-8167 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-06-24 |
Last Update Date: | 2016-08-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | M0212 | 207R00000X |
IN | 01069679A | 207R00000X |
FL | ME128354 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
IN | 201024920 | Medicaid | |
IN | 000000735865 | Other | BCBS |
TX | 8J3545 | Medicare PIN | |
IN | M400057626 | Medicare PIN | |
IN | P00999234 | Medicare PIN | |
IN | 201024920 | Medicaid |