Provider Demographics
NPI:1174238570
Name:PARKERLAWS, TAJUANA RENEA
Entity type:Individual
Prefix:
First Name:TAJUANA
Middle Name:RENEA
Last Name:PARKERLAWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24502 FOREST PATH CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-7672
Mailing Address - Country:US
Mailing Address - Phone:832-642-2777
Mailing Address - Fax:281-651-9085
Practice Address - Street 1:24502 FOREST PATH CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-7672
Practice Address - Country:US
Practice Address - Phone:832-642-2777
Practice Address - Fax:281-651-9085
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18056851172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000OtherNONE