Provider Demographics
NPI:1144523549
Name:PARAVA, PRATYUSHA (MD)
Entity type:Individual
Prefix:
First Name:PRATYUSHA
Middle Name:
Last Name:PARAVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 ANDREWS HWY
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-5130
Mailing Address - Country:US
Mailing Address - Phone:432-262-1948
Mailing Address - Fax:
Practice Address - Street 1:3305 ANDREWS HWY # B1
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-5130
Practice Address - Country:US
Practice Address - Phone:432-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK30441207RG0100X
TXR3933207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology