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NPI Code Detail

MEDICARE: DR. PARISA IBRAHIM M.D.

MEDICARE: DR. PARISA IBRAHIM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianP2681TX
2207R00000XInternal Medicine Physician01069413AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
191969413AOTHERINLICENSE
2P2681OTHERTXLICENSE

General Provider Information

NPI Number : 1386804326
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PARISA IBRAHIM M.D.
Provider Business Mailing Address
First Line : 1600 MEDICAL CENTER DR STE 309
Second Line :
City : EL PASO
State : TX
Zip : 79902-5008
Country : US
Telephone Number : 915-533-6690
Fax Number : 915-532-3848
Provider Business Practice Location Address
First Line : 631 N RESLER DR
Second Line : SUITE 101
City : EL PASO
State : TX
Zip : 79912-2382
Country : US
Telephone Number : 915-842-0676
Fax Number : 915-842-0676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2008
Last Update Date : 02/20/2026

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