Healthcare Provider Details

I. General information

NPI: 1003220195
Provider Name (Legal Business Name): VLADIMIR M. PARUNGAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8302 HERTS RD
SPRING TX
77379-6716
US

IV. Provider business mailing address

8302 HERTS RD
SPRING TX
77379-6716
US

V. Phone/Fax

Practice location:
  • Phone: 281-370-1247
  • Fax:
Mailing address:
  • Phone: 281-370-1247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License NumberF1187
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberF1187
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: