=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669771648
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERT G PARKER DPM PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2011
-----------------------------------------------------
Last Update Date | 12/03/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14441 MEMORIAL DR SUITE #16
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77079-6744
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-497-2850
-----------------------------------------------------
Fax | 281-531-7910
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14441 MEMORIAL DR SUITE #16
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77079-6744
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-497-2850
-----------------------------------------------------
Fax | 281-531-7910
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ROBERT G. PARKER
-----------------------------------------------------
Credential | D.P.M.
-----------------------------------------------------
Telephone | 281-497-2850
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | 0382
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------