Provider Demographics
NPI:1558331413
Name:LINDA I PARKER MD PA
Entity Type:Organization
Organization Name:LINDA I PARKER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLO PRACTITIONER 100 STOCKHOLDER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:IMOGENE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-727-8000
Mailing Address - Street 1:311 N ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2539
Mailing Address - Country:US
Mailing Address - Phone:972-727-8000
Mailing Address - Fax:972-727-0842
Practice Address - Street 1:311 N ALLEN DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2539
Practice Address - Country:US
Practice Address - Phone:972-727-8000
Practice Address - Fax:972-727-0842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC20205Medicare PIN
TX00A46KMedicare ID - Type Unspecified