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General NPI Number Information
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NPI Number | 1144111568
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Entity Type | Individual
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Provider Name | RANDIKA PARAKRAMAWEERA DO
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Gender |
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1201 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1016
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Country | US
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Telephone | 314-617-2408
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Fax |
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Provider Business Mailing Address
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Address Line | 4618 RAINBOW VALLEY CT
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City | MISSOURI CITY
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State | TX
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Zip | 77459-4508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2025028823
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | 2025028823
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License Number State | MO
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