MEDICARE: HOLLY DENE PARKS

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	1041C0700X	Clinical Social Worker	416513	TX

General Provider Information

NPI Number	:	1407709983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY DENE PARKS

Provider Business Mailing Address
First Line	:	3517 COLORADO HIGH AVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-3338
Country	:	US
Telephone Number	:	512-698-5671
Fax Number	:

Provider Business Practice Location Address
First Line	:	3517 COLORADO HIGH AVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-3338
Country	:	US
Telephone Number	:	512-698-5671
Fax Number	:

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “ HOLLY DENE PARKS ” Practice Location

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