Provider Demographics
NPI:1710213145
Name:PARKS, ANTHONY LLOYD (CFA)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LLOYD
Last Name:PARKS
Suffix:
Gender:M
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 UNIVERSITY BLVD APT 1118
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-8018
Mailing Address - Country:US
Mailing Address - Phone:410-419-9532
Mailing Address - Fax:
Practice Address - Street 1:1700 UNIVERSITY BLVD APT 1118
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8018
Practice Address - Country:US
Practice Address - Phone:410-419-9532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ112784246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant