Provider Demographics
NPI:1659797926
Name:PARKER, DENISE DIERKSEN (DC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:DIERKSEN
Last Name:PARKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N MILL ST
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3938
Mailing Address - Country:US
Mailing Address - Phone:972-951-9355
Mailing Address - Fax:214-764-0694
Practice Address - Street 1:200 N MILL ST
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3938
Practice Address - Country:US
Practice Address - Phone:972-951-9355
Practice Address - Fax:214-764-0694
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12524111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist