Provider Demographics
NPI:1891945457
Name:PARKS, JAMES M (PA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:PARKS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:2200 PARK BEND DR
Mailing Address - Street 2:BLDG 2, STE 202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5388
Mailing Address - Country:US
Mailing Address - Phone:512-836-0900
Mailing Address - Fax:512-836-0902
Practice Address - Street 1:2200 PARK BEND DR.
Practice Address - Street 2:BLDG 2, STE. 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5388
Practice Address - Country:US
Practice Address - Phone:512-836-0900
Practice Address - Fax:512-836-0902
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2012-05-22
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Provider Licenses
StateLicense IDTaxonomies
LAPA.A10579363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAQ33440Medicare UPIN