Provider Demographics
NPI:1144482332
Name:PARKER, DAVID (BS, LMT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:BS, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 BRADFORD PEAR SQ
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5791
Mailing Address - Country:US
Mailing Address - Phone:214-732-8887
Mailing Address - Fax:
Practice Address - Street 1:1921 BRADFORD PEAR SQ
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5791
Practice Address - Country:US
Practice Address - Phone:214-732-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT34641225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist