Provider Demographics
NPI:1518058270
Name:PARVEEN, TALAT (MD)
Entity type:Individual
Prefix:
First Name:TALAT
Middle Name:
Last Name:PARVEEN
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:PO BOX 676512
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-6512
Mailing Address - Country:US
Mailing Address - Phone:713-481-3594
Mailing Address - Fax:615-234-3774
Practice Address - Street 1:4600 E SAM HOUSTON PKWY SOUTH
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3948
Practice Address - Country:US
Practice Address - Phone:713-481-3594
Practice Address - Fax:713-481-3588
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60385207ZP0102X
GA051528207ZP0102X
TXS4208207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10054281OtherAMERIGROUP GA MEDICAIDCMO
GA52887253004OtherBLUE CROSS
GA678066794DMedicaid
GA319813OtherWELLCARE MEDICAID GA CMO
F31690Medicare UPIN
GA10054281OtherAMERIGROUP GA MEDICAIDCMO