Provider Demographics
NPI:1679898555
Name:IMPERIAL INFUSIONS PA
Entity Type:Organization
Organization Name:IMPERIAL INFUSIONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:PALWAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-340-0952
Mailing Address - Street 1:55 WIND RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-6304
Mailing Address - Country:US
Mailing Address - Phone:936-340-0952
Mailing Address - Fax:936-340-0952
Practice Address - Street 1:55 WIND RIDGE CIR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77381-6304
Practice Address - Country:US
Practice Address - Phone:936-340-0952
Practice Address - Fax:936-340-0952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1284261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service