Provider Demographics
NPI:1205371739
Name:PARKS, HEATHER (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:PARKS
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SETON PKWY
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-8000
Mailing Address - Country:US
Mailing Address - Phone:512-324-4000
Mailing Address - Fax:
Practice Address - Street 1:201 SETON PKWY
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8000
Practice Address - Country:US
Practice Address - Phone:512-324-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132752363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care