Provider Demographics
NPI:1457540882
Name:PARVEEN, RUBY J (MD)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:J
Last Name:PARVEEN
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 1:4201 GARTH RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3167
Mailing Address - Country:US
Mailing Address - Phone:832-556-6535
Mailing Address - Fax:281-427-3767
Practice Address - Street 1:4201 GARTH RD
Practice Address - Street 2:SUITE 208
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3167
Practice Address - Country:US
Practice Address - Phone:832-556-6535
Practice Address - Fax:281-427-3767
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV220852084N0400X, 2084S0012X
TXP42242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8ET107OtherBCBS
TX346835701Medicaid
TX8GD850OtherBCBS
WV3810010690Medicaid
TX346835701Medicaid
WVG99661Medicare PIN
PA4221351Medicare PIN
TX373971YKUKMedicare PIN
TX8ET107OtherBCBS