Provider Demographics
NPI:1609874155
Name:PARKER, BARBARA JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JEAN
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 BOLTON BOONE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2078
Mailing Address - Country:US
Mailing Address - Phone:872-572-5582
Mailing Address - Fax:972-572-5583
Practice Address - Street 1:2715 BOLTON BOONE DR
Practice Address - Street 2:SUITE C
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2078
Practice Address - Country:US
Practice Address - Phone:872-572-5582
Practice Address - Fax:972-572-5583
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51112231H00000X
TX17154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094627902Medicaid