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General NPI Number Information
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NPI Number | 1881261501
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Entity Type | Individual
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Provider Name | PARKER ANSON TOLIVER DC
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Gender | Male
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 09/14/2024
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Provider Practice Location Address
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Address Line | 314 S SHADY SHORES DR STE 100
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City | LAKE DALLAS
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State | TX
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Zip | 75065-3609
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Country | US
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Telephone | 972-754-1143
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Fax |
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Provider Business Mailing Address
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Address Line | 108 KINGS ROW
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City | MALAKOFF
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State | TX
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Zip | 75148-9360
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Country | US
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Telephone | 972-754-1143
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 14528
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14528
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License Number State | TX
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