Provider Demographics
NPI:1962478958
Name:PARKER, DEBORAH A (PHD)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:A
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4031 W PLANO PKWY
Mailing Address - Street 2:SUITE 213
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5619
Mailing Address - Country:US
Mailing Address - Phone:972-599-1953
Mailing Address - Fax:972-675-3989
Practice Address - Street 1:4031 W PLANO PKWY
Practice Address - Street 2:STE 213
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5631
Practice Address - Country:US
Practice Address - Phone:972-599-1953
Practice Address - Fax:972-675-3989
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23569103TB0200X, 103TC1900X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX032705801Medicaid
TXPARKE-0006OtherCOMPCARE
TX032705801Medicaid
TX00D84BMedicare ID - Type Unspecified