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General NPI Number Information
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NPI Number | 1982815965
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Entity Type | Individual
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Provider Name | TOMASINA Q PARKER-ACTLIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 1501 KINGS HWY DEPARTMENT OF ANESTHESIOLOGY
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City | SHREVEPORT
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State | LA
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Zip | 71103-4228
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Country | US
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Telephone | 318-675-5300
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Fax | 318-675-5666
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Provider Business Mailing Address
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Address Line | 1501 KINGS HWY DEPARTMENT OF ANESTHESIOLOGY
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City | SHREVEPORT
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State | LA
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Zip | 71103-4228
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Country | US
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Telephone | 318-675-5300
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Fax | 318-675-5666
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD 202633
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License Number State | LA
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