Provider Demographics
NPI:1013075589
Name:PARKER, RONNIE MILAM (MA)
Entity Type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:MILAM
Last Name:PARKER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804-0004
Mailing Address - Country:US
Mailing Address - Phone:325-643-3143
Mailing Address - Fax:325-641-0059
Practice Address - Street 1:2700 HIGHWAY 377 S
Practice Address - Street 2:SUITE 115
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-3902
Practice Address - Country:US
Practice Address - Phone:325-643-3143
Practice Address - Fax:325-641-0059
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11341101YP2500X
TX4183106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist