Provider Demographics
NPI:1265731806
Name:PARKS&COMBS ASSOICATES
Entity type:Organization
Organization Name:PARKS&COMBS ASSOICATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-234-6067
Mailing Address - Street 1:5350 S WESTERN AVE
Mailing Address - Street 2:SUITE 305A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-4520
Mailing Address - Country:US
Mailing Address - Phone:403-234-6067
Mailing Address - Fax:
Practice Address - Street 1:1330 N CLASSEN BLVD
Practice Address - Street 2:SUTIE 315
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6835
Practice Address - Country:US
Practice Address - Phone:405-234-6067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty