Provider Demographics
NPI:1245083724
Name:TIUMENTSEV, PARRIS (CD(DONA))
Entity type:Individual
Prefix:
First Name:PARRIS
Middle Name:
Last Name:TIUMENTSEV
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3451 MAYFIELD RANCH BLVD UNIT 503
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2469
Mailing Address - Country:US
Mailing Address - Phone:512-668-2121
Mailing Address - Fax:
Practice Address - Street 1:3451 MAYFIELD RANCH BLVD UNIT 503
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2469
Practice Address - Country:US
Practice Address - Phone:512-668-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL15448374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula