Provider Demographics
NPI:1205427655
Name:PARULIAN, PAMELA (RD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:PARULIAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 GRAHAM RD STE 400
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-9666
Mailing Address - Country:US
Mailing Address - Phone:979-201-8848
Mailing Address - Fax:877-334-3237
Practice Address - Street 1:1200 DEACON DR
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-6403
Practice Address - Country:US
Practice Address - Phone:979-777-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82133133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered