Provider Demographics
NPI:1578936159
Name:PARKER, DIONY (COTA)
Entity Type:Individual
Prefix:
First Name:DIONY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 E LEAGUE CITY PKWY
Mailing Address - Street 2:APT 1209
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-1664
Mailing Address - Country:US
Mailing Address - Phone:409-795-1940
Mailing Address - Fax:
Practice Address - Street 1:3501 CHENEVERT ST
Practice Address - Street 2:#24
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-4198
Practice Address - Country:US
Practice Address - Phone:409-795-1940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
TX211560251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No171W00000XOther Service ProvidersContractor