Provider Demographics
NPI:1770744245
Name:PARMAR, STAVAN PANKAJ (MD)
Entity type:Individual
Prefix:
First Name:STAVAN
Middle Name:PANKAJ
Last Name:PARMAR
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 1:130 MEDICAL CENTER PKWY STE 10
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4944
Mailing Address - Country:US
Mailing Address - Phone:936-435-0833
Mailing Address - Fax:
Practice Address - Street 1:130 MEDICAL CENTER PKWY STE 10
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4944
Practice Address - Country:US
Practice Address - Phone:936-435-0833
Practice Address - Fax:936-435-0395
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP20032647208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery