Provider Demographics
NPI:1396345559
Name:PARISHE, VIKRAM
Entity type:Individual
Prefix:
First Name:VIKRAM
Middle Name:
Last Name:PARISHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12220 FM 423
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-5222
Mailing Address - Country:US
Mailing Address - Phone:469-362-8641
Mailing Address - Fax:469-362-8644
Practice Address - Street 1:12220 FM 423
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-5222
Practice Address - Country:US
Practice Address - Phone:469-362-8641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist