Provider Demographics
NPI:1770552150
Name:JOSHI, PREMAL PARIMAL (MD)
Entity type:Individual
Prefix:
First Name:PREMAL
Middle Name:PARIMAL
Last Name:JOSHI
Suffix:
Gender:M
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:PO BOX 17929
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-7929
Mailing Address - Country:US
Mailing Address - Phone:281-207-6409
Mailing Address - Fax:281-207-6438
Practice Address - Street 1:16605 SOUTHWEST FWY STE 350
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3482
Practice Address - Country:US
Practice Address - Phone:281-207-6409
Practice Address - Fax:281-207-6438
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0146207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN10646184OtherCAQH NUMBER
INI14239Medicare UPIN