MEDICARE: DR. ADAM NATHANIEL PARKER DDS

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	1223P0221X	Pediatric Dentistry	D11423	OR
2	1223P0221X	Pediatric Dentistry	39854	TX

General Provider Information

NPI Number	:	1851829162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM NATHANIEL PARKER DDS

Provider Business Mailing Address
First Line	:	1803 POLO RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-3134
Country	:	US
Telephone Number	:	865-789-3854
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 W 38TH ST STE 102
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-1042
Country	:	US
Telephone Number	:	512-330-4624
Fax Number	:

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

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	05/21/2025

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