Healthcare Provider Details

I. General information

NPI: 1134836943
Provider Name (Legal Business Name): KATHERINE R PARMLEY PA-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 5TH AVE STE 400
FORT WORTH TX
76104-7305
US

IV. Provider business mailing address

800 5TH AVE STE 400
FORT WORTH TX
76104-7305
US

V. Phone/Fax

Practice location:
  • Phone: 817-761-7740
  • Fax:
Mailing address:
  • Phone: 817-761-7740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA17647
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: