Provider Demographics
NPI:1831878552
Name:PUTHIYA PARAMBATH, SREEMA
Entity type:Individual
Prefix:
First Name:SREEMA
Middle Name:
Last Name:PUTHIYA PARAMBATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 BOLTON DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7142
Mailing Address - Country:US
Mailing Address - Phone:832-745-1088
Mailing Address - Fax:
Practice Address - Street 1:409 BOLTON DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7142
Practice Address - Country:US
Practice Address - Phone:832-745-1088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program