MEDICARE: DR. LAWRENCE WAYNE PARKS JR. D.C.

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	111N00000X	Chiropractor	9035	TX

General Provider Information

NPI Number	:	1427270024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE WAYNE PARKS JR. D.C.

Provider Business Mailing Address
First Line	:	6124 CRYSTAL CASCADE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1531
Country	:	US
Telephone Number	:	832-561-5803
Fax Number	:

Provider Business Practice Location Address
First Line	:	1321 S RAINBOW BLVD
Second Line	:	SUITE 201
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-9066
Country	:	US
Telephone Number	:	832-580-2465
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/31/2015

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