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General NPI Number Information
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NPI Number | 1831189794
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Entity Type | Individual
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Provider Name | ALLAN S PARKE DDS
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Gender | Male
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 1615 TRUEMPER ST BLDG 6418
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City | JBSA LACKLAND
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State | TX
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Zip | 78236-5511
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Country | US
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Telephone | 210-292-1035
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Fax |
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Provider Business Mailing Address
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Address Line | 16424 REVELLO DR
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City | HELOTES
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State | TX
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Zip | 78023-5159
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Country | US
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Telephone | 850-461-6839
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 34855
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License Number State | TX
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