MEDICARE: JAMES EDWARD PARRIS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0000000	IL
2	363AM0700X	Medical Physician Assistant	000000000	TX
3	363A00000X	Physician Assistant	PA07421	TX

General Provider Information

NPI Number	:	1063408599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES EDWARD PARRIS PA

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5347
Country	:	US
Telephone Number	:	214-648-3916
Fax Number	:	214-648-8423

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7208
Country	:	US
Telephone Number	:	214-648-3916
Fax Number	:	214-648-8423

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	09/16/2014

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