Healthcare Provider Details

I. General information

NPI: 1376784744
Provider Name (Legal Business Name): EHRIN PARKER DO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 03/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E PALM VALLEY BLVD SUITE 230
ROUND ROCK TX
78664-3041
US

IV. Provider business mailing address

505 E PALM VALLEY BLVD STE 230
ROUND ROCK TX
78664-3043
US

V. Phone/Fax

Practice location:
  • Phone: 512-310-7177
  • Fax: 512-246-0045
Mailing address:
  • Phone: 512-310-7177
  • Fax: 512-246-0045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberK4980
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK4980
License Number StateTX

VIII. Authorized Official

Name: DR. EHRIN ELAINE PARKER
Title or Position: OWNER
Credential: DO
Phone: 512-310-7177