Provider Demographics
NPI:1154329894
Name:PARKE, ROBERT B (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:PARKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1701-ATT RENEE BROWN
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-798-8291
Mailing Address - Fax:713-798-5294
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1701-ATT RENEE BROWN
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-798-8291
Practice Address - Fax:713-798-5294
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1918207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128568604Medicaid
TX88H559Medicare PIN
TXTXB119018Medicare PIN
C20191Medicare UPIN
TX88G294Medicare PIN