Provider Demographics
NPI:1578953444
Name:PARMAR, AUDREY LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:LYNN
Last Name:PARMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AUDREY
Other - Middle Name:LYNN
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3533 S. ALAMEDA ST. #303
Mailing Address - Street 2:JOSEPH SLOAN MEDICAL CENTER
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1721
Mailing Address - Country:US
Mailing Address - Phone:361-853-3222
Mailing Address - Fax:361-853-7311
Practice Address - Street 1:3533 S. ALAMEDA ST. #303
Practice Address - Street 2:JOSEPH SLOAN MEDICAL CENTER
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-7841
Practice Address - Country:US
Practice Address - Phone:361-853-3222
Practice Address - Fax:361-853-7311
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6451208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX385699901Medicaid