Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | F1187 | TX |
NPI | 1003220195 |
---|---|
Provider Name | Dr. Vladimir M. Parungao |
First Address | Spring, TX 77379-6716 |
Second Address | Spring, TX 77379-6716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2014 |
Last Update Date | 17/06/2014 |