Provider Demographics
NPI:1417588914
Name:PARKS, ADRIAN LYNN
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:LYNN
Last Name:PARKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3395 ASHTON SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5305
Mailing Address - Country:US
Mailing Address - Phone:713-417-1992
Mailing Address - Fax:
Practice Address - Street 1:7747 KIRBY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4309
Practice Address - Country:US
Practice Address - Phone:713-661-7440
Practice Address - Fax:713-661-7562
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist