MEDICARE: LURINE 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	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	444213	TX

General Provider Information

NPI Number	:	1669483822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LURINE PARKER

Provider Business Mailing Address
First Line	:	3026 GRASSMERE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-3514
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3026 GRASSMERE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-3514
Country	:	US
Telephone Number	:	173-264-7720
Fax Number	:

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/08/2007

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Directions to “ LURINE PARKER ” Practice Location

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