Healthcare Provider Details

I. General information

NPI: 1194740597
Provider Name (Legal Business Name): DAVID R PARKER JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4541 N JOSEY LN STE 110
CARROLLTON TX
75010-4622
US

IV. Provider business mailing address

4541 N JOSEY LN STE 110
CARROLLTON TX
75010-4622
US

V. Phone/Fax

Practice location:
  • Phone: 469-788-8588
  • Fax: 469-788-7800
Mailing address:
  • Phone: 469-788-8588
  • Fax: 469-788-7800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberH3136
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH3136
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: