Provider Demographics
NPI:1073928073
Name:PARRA, JENNIFER (MA, CNIM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:PARRA
Suffix:
Gender:F
Credentials:MA, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 MULBERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5540
Mailing Address - Country:US
Mailing Address - Phone:832-474-4901
Mailing Address - Fax:
Practice Address - Street 1:2150 TOWN SQUARE PLACE
Practice Address - Street 2:SUITE 290
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1643
Practice Address - Country:US
Practice Address - Phone:281-768-6730
Practice Address - Fax:281-768-6766
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
2856OtherABRET CERTIFICATION FOR CNIM