Provider Demographics
NPI:1710985916
Name:RAWAL, PARESH A (MD)
Entity Type:Individual
Prefix:
First Name:PARESH
Middle Name:A
Last Name:RAWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 POINT WEST PKWY
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-2193
Mailing Address - Country:US
Mailing Address - Phone:806-510-4244
Mailing Address - Fax:806-510-7211
Practice Address - Street 1:1660 POINT WEST PKWY
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-2193
Practice Address - Country:US
Practice Address - Phone:806-510-4244
Practice Address - Fax:806-510-7211
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8639207RC0000X
IL036084795207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX418422801Medicaid
IL0005632546OtherBCBS OF IL
IL0005632546OtherBCBS OF IL
IL060070907Medicare PIN
ILIL6627001Medicare PIN
ILIL6628001Medicare PIN
ILG52734Medicare UPIN
IL060070905Medicare PIN
ILL88404Medicare PIN