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General NPI Number Information
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NPI Number | 1689060782
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Entity Type | Individual
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Provider Name | JOE PARKER LCDC
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Gender | Male
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 6699 PORTWEST DR STE 150
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City | HOUSTON
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State | TX
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Zip | 77024-8078
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Country | US
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Telephone | 713-520-6720
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Fax |
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Provider Business Mailing Address
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Address Line | 11007 JACOB CROSSING DR
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City | RICHMOND
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State | TX
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Zip | 77406-1401
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Country | US
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Telephone | 713-351-9387
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12912
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License Number State | TX
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