MEDICARE: DR. AUDREY LYNN PARMAR 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
1	208000000X	Pediatrics Physician	R6451	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578953444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUDREY LYNN PARMAR M.D.

Provider Business Mailing Address
First Line	:	3533 S. ALAMEDA ST. #303
Second Line	:	JOSEPH SLOAN MEDICAL CENTER
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-1721
Country	:	US
Telephone Number	:	361-853-3222
Fax Number	:	361-853-7311

Provider Business Practice Location Address
First Line	:	3533 S. ALAMEDA ST. #303
Second Line	:	JOSEPH SLOAN MEDICAL CENTER
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-7841
Country	:	US
Telephone Number	:	361-853-3222
Fax Number	:	361-853-7311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2015
Last Update Date	:	10/25/2018

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