Healthcare Provider Details

I. General information

NPI: 1073886008
Provider Name (Legal Business Name): DI LIN PARKS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. DI LIN

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S MAIN ST
FORT WORTH TX
76104-4917
US

IV. Provider business mailing address

PO BOX 732973
DALLAS TX
75373-2973
US

V. Phone/Fax

Practice location:
  • Phone: 817-702-3000
  • Fax: 817-927-3958
Mailing address:
  • Phone: 817-702-2450
  • Fax: 817-702-7315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA125843
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberP3408
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: