Provider Demographics
NPI:1295859437
Name:PARKS, SANDRA ANITA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ANITA
Last Name:PARKS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:ANITA
Other - Last Name:KRASTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:9601 ROYAL LYTHAM DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5163
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:972-644-3031
Practice Address - Street 1:1301 N PLANO RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2426
Practice Address - Country:US
Practice Address - Phone:972-644-2273
Practice Address - Fax:972-783-0848
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist