Provider Demographics
NPI:1437477346
Name:TAMEZ PARLETT, DOLORES ELIZONDO (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DOLORES
Middle Name:ELIZONDO
Last Name:TAMEZ PARLETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DOLORES
Other - Middle Name:ELIZONDO
Other - Last Name:TAMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:
Practice Address - Street 1:611 DENBIGH BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-4415
Practice Address - Country:US
Practice Address - Phone:757-283-8300
Practice Address - Fax:951-601-2316
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003881363A00000X
CAPA 13799363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMT1908500OtherDEA