Healthcare Provider Details

I. General information

NPI: 1215138599
Provider Name (Legal Business Name): THORNWELL H PARKER III M D P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 WALNUT HILL LN STE 808
DALLAS TX
75231-4469
US

IV. Provider business mailing address

8230 WALNUT HILL LN STE 808
DALLAS TX
75231-4469
US

V. Phone/Fax

Practice location:
  • Phone: 214-696-8828
  • Fax: 214-696-1444
Mailing address:
  • Phone: 214-696-8828
  • Fax: 214-696-1444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberM4907
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberM4907
License Number StateTX

VIII. Authorized Official

Name: DR. THORNWELL HAY PARKER III
Title or Position: PRESIDENT
Credential: M.D.
Phone: 214-696-8828