MEDICARE: DR. PHILIP J PARR DPM

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	213EP1101X	Primary Podiatric Medicine Podiatrist	2154	TX
2	213ES0103X	Foot & Ankle Surgery Podiatrist	2154	TX

General Provider Information

NPI Number	:	1861755829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP J PARR DPM

Provider Business Mailing Address
First Line	:	7100 OAKMONT BLVD STE 107
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3911
Country	:	US
Telephone Number	:	682-231-0779
Fax Number	:	833-463-1739

Provider Business Practice Location Address
First Line	:	7100 OAKMONT BLVD STE 107
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3911
Country	:	US
Telephone Number	:	682-231-0779
Fax Number	:	833-463-1739

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

Provider Enumeration Date	:	06/24/2012
Last Update Date	:	04/30/2025

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