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General NPI Number Information
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NPI Number | 1992452569
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Entity Type | Individual
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Provider Name | MADISON MARGARET PARKS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 8651 JOHN T WHITE RD STE 121
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City | FORT WORTH
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State | TX
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Zip | 76120-2766
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Country | US
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Telephone | 817-542-0714
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 BLEECKER ST APT 411
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City | COPPELL
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State | TX
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Zip | 75019-5381
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Country | US
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Telephone | 918-845-5110
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1357797
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License Number State | TX
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