Provider Demographics
NPI:1437442514
Name:PARKER PLACE CPW
Entity Type:Organization
Organization Name:PARKER PLACE CPW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LORNIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-449-3233
Mailing Address - Street 1:10914 BRIDLEPARK CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016-1890
Mailing Address - Country:US
Mailing Address - Phone:281-449-3233
Mailing Address - Fax:281-449-3230
Practice Address - Street 1:11510 HOMESTEAD RD
Practice Address - Street 2:SUITE 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016-1237
Practice Address - Country:US
Practice Address - Phone:281-449-3233
Practice Address - Fax:281-449-3230
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKER PLACE PROPERTY OWNERS ASSOCIATION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX215219101Medicaid
TXTXB107919OtherMEDICARE PTAN
TX215219102Medicaid
TX215219103Medicaid