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NPI Code Detail

MEDICARE: DR. KATRINA PARKER O.D.

MEDICARE: DR. KATRINA PARKER O.D.
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
1152W00000XOptometrist6142TGTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700889045
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATRINA PARKER O.D.
Provider Business Mailing Address
First Line : PO BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-5347
Country : US
Telephone Number : 214-645-2020
Fax Number : 214-645-2011
Provider Business Practice Location Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-645-2020
Fax Number : 214-645-2011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 09/08/2016

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