Provider Demographics
NPI:1568758126
Name:MEDINA PARRILLA, NADYA (MD)
Entity Type:Individual
Prefix:
First Name:NADYA
Middle Name:
Last Name:MEDINA PARRILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 ABERDEEN WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-2308
Mailing Address - Country:US
Mailing Address - Phone:713-777-1117
Mailing Address - Fax:
Practice Address - Street 1:6445 HIGH STAR DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-5005
Practice Address - Country:US
Practice Address - Phone:713-777-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2017-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19911208000000X
TXR0617208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics