Provider Demographics
NPI:1255891917
Name:PLASENCIA, VERIAH BRISELLE (MD)
Entity type:Individual
Prefix:
First Name:VERIAH
Middle Name:BRISELLE
Last Name:PLASENCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 W PANTHER CREEK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-2568
Mailing Address - Country:US
Mailing Address - Phone:281-364-8600
Mailing Address - Fax:
Practice Address - Street 1:4800 W PANTHER CREEK DR STE 100
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-2568
Practice Address - Country:US
Practice Address - Phone:281-364-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA176403208000000X
390200000X
TXU1355208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty