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General NPI Number Information
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NPI Number | 1861506032
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Entity Type | Individual
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Provider Name | MARY RILEY PARKER MD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 19016 STONE OAK PKWY STE 180
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3281
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Country | US
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Telephone | 210-504-4304
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Fax | 210-504-4303
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Provider Business Mailing Address
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Address Line | 8135 FOREST LN # 515057
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City | DALLAS
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State | TX
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Zip | 75230-2472
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Country | US
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Telephone |
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | H8308
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | H8308
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | H8308
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License Number State | TX
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