MEDICARE: EHRIN E PARKER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	K4980	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0097DP	OTHER	TX	BLUE CROSS

General Provider Information

NPI Number	:	1285728766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EHRIN E PARKER DO

Provider Business Mailing Address
First Line	:	405 OLD WEST DRIVE
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-7452
Country	:	US
Telephone Number	:	512-255-3631
Fax Number	:	512-255-3972

Provider Business Practice Location Address
First Line	:	405 OLD WEST DRIVE
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-7452
Country	:	US
Telephone Number	:	512-255-3631
Fax Number	:	512-255-3972

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/09/2007

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Directions to “ EHRIN E PARKER DO” Practice Location

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