Provider Demographics
NPI:1790377869
Name:PARRA, MARIA SOCORRO
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SOCORRO
Last Name:PARRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 S LINDSAY RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-7108
Mailing Address - Country:US
Mailing Address - Phone:480-892-6772
Mailing Address - Fax:480-892-6923
Practice Address - Street 1:1916 S LINDSAY RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-7108
Practice Address - Country:US
Practice Address - Phone:480-892-6772
Practice Address - Fax:480-892-6923
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZT015853183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician