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General NPI Number Information
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NPI Number | 1922515048
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Entity Type | Organization
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Legal Business Name | CARROLLTON PRIMARY CARE MEDICINE PLLC
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 1809 GOLDEN TRAIL CT STE 240
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City | CARROLLTON
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State | TX
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Zip | 75010-4667
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Country | US
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Telephone | 972-939-0427
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Fax |
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Provider Business Mailing Address
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Address Line | 1128 MUSCOGEE TRL
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City | CARROLLTON
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State | TX
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Zip | 75010-1130
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Country | US
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Telephone | 214-394-0959
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DAVID RONALD PARKER JR.
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Credential | M.D.
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Telephone | 214-394-0959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H3136
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License Number State | TX
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