MEDICARE: DR. ROBERT G PARHAM MD

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	208800000X	Urology Physician	J2251	TX
2	208800000X	Urology Physician	66564	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437151487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT G PARHAM MD

Provider Business Mailing Address
First Line	:	1101 6TH AVE STE 110
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4929
Country	:	US
Telephone Number	:	817-912-8040
Fax Number	:	817-912-8049

Provider Business Practice Location Address
First Line	:	1101 6TH AVE STE 110
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4929
Country	:	US
Telephone Number	:	817-912-8040
Fax Number	:	817-912-8049

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	04/12/2024

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