MEDICARE: MRS. ROBERTA PARKER

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1437479870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBERTA PARKER

Provider Business Mailing Address
First Line	:	5422 OAK COVE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-3612
Country	:	US
Telephone Number	:	713-812-1801
Fax Number	:	713-812-0126

Provider Business Practice Location Address
First Line	:	5422 OAK COVE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-3612
Country	:	US
Telephone Number	:	713-812-1801
Fax Number	:	713-812-0126

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

Provider Enumeration Date	:	06/08/2010
Last Update Date	:	06/08/2010

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Directions to “ MRS. ROBERTA PARKER ” Practice Location

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