Provider Demographics
NPI:1689715252
Name:PARKHILL PHYSICIAN GROUP, PLLC
Entity Type:Organization
Organization Name:PARKHILL PHYSICIAN GROUP, PLLC
Other - Org Name:AEGIS ANESTHESIA, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:WYANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-300-3131
Mailing Address - Street 1:7000 W PLANO PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8465
Mailing Address - Country:US
Mailing Address - Phone:469-300-3131
Mailing Address - Fax:214-723-7582
Practice Address - Street 1:7000 W PLANO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8465
Practice Address - Country:US
Practice Address - Phone:469-300-3131
Practice Address - Fax:214-723-7582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric AnesthesiologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150096901Medicaid
TX150096901Medicaid