Basic Information
| Provider Information | |||||||||
| NPI: | 1700992641 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALVADI | ||||||||
| FirstName: | PRITI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6400 FANNIN ST STE 2070 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770301521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137046731 | ||||||||
| FaxNumber: | 7137041796 | ||||||||
| Practice Location | |||||||||
| Address1: | 4141 VISTA RD | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775042113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139473100 | ||||||||
| FaxNumber: | 7139476103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 02/03/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | N3226 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084S0012X | N3226 | TX | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine | 2084N0600X | N3226 | TX | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Clinical Neurophysiology |
ID Information
| ID | Type | State | Issuer | Description | 00106W | 01 | TX | MDCR GRP PTAN HARRIS CO | OTHER | 302679101 | 01 | TX | MDCD GRP TPI BRAZORIA CO | OTHER | DB6392 | 01 | TX | RR MDCR GRP PTAN | OTHER | 00X185 | 01 | TX | MDCR GRP PTAN BRAZORIA CO | OTHER | 153449704 | 01 | TX | MDCD GRP TPI HARRIS CO | OTHER |