Provider Demographics
NPI:1336117274
Name:TOWNSEND-PARCHMAN, WALLACE ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:WALLACE
Middle Name:ROBERT
Last Name:TOWNSEND-PARCHMAN
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 1:207 WEST HICKORY ST
Mailing Address - Street 2:STE 110
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201
Mailing Address - Country:US
Mailing Address - Phone:940-243-9367
Mailing Address - Fax:940-243-0398
Practice Address - Street 1:207 WEST HICKORY ST
Practice Address - Street 2:STE 110
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-243-9367
Practice Address - Fax:940-243-0398
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF76832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00D73EMedicare ID - Type Unspecified
E17860Medicare UPIN