Provider Demographics
NPI:1255890182
Name:PARAMESWARANUNNI, RESHMIBHAT
Entity type:Individual
Prefix:
First Name:RESHMIBHAT
Middle Name:
Last Name:PARAMESWARANUNNI
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 1:204 W PARK STE 200
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-9337
Mailing Address - Country:US
Mailing Address - Phone:936-327-4660
Mailing Address - Fax:
Practice Address - Street 1:204 W PARK STE 200
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-9337
Practice Address - Country:US
Practice Address - Phone:936-327-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT5185208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program