Basic Information
Provider Information
NPI: 1770836249
EntityType: 2
ReplacementNPI:  
OrganizationName: PARAMUS DIAGNOSITCS PLLC
LastName:  
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Credential:  
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Mailing Information
Address1: 13161 MISTY WILLOW DR
Address2:  
City: HOUSTON
State: TX
PostalCode: 770705635
CountryCode: US
TelephoneNumber: 2819705900
FaxNumber: 2819705913
Practice Location
Address1: 13161 MISTY WILLOW DR
Address2:  
City: HOUSTON
State: TX
PostalCode: 770705635
CountryCode: US
TelephoneNumber: 2819705900
FaxNumber: 2819705913
Other Information
ProviderEnumerationDate: 10/22/2012
LastUpdateDate: 10/22/2012
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: JABERANSARI
AuthorizedOfficialFirstName: SHIDA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MANAGER
AuthorizedOfficialTelephone: 2819705900
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X  Y193400000X SINGLE SPECIALTY GROUPOther Service ProvidersSpecialist 

No ID Information.


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