Provider Demographics
NPI:1457478463
Name:PARKS, N. PAULINE THOMAS (RPH)
Entity Type:Individual
Prefix:
First Name:N. PAULINE
Middle Name:THOMAS
Last Name:PARKS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 FOXGLOVE DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3237
Mailing Address - Country:US
Mailing Address - Phone:281-437-2704
Mailing Address - Fax:281-835-5025
Practice Address - Street 1:715 FOXGLOVE DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3237
Practice Address - Country:US
Practice Address - Phone:281-437-2704
Practice Address - Fax:281-835-5025
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist