Provider Demographics
NPI:1508816117
Name:PARKER, JAMES TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:TIMOTHY
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 S US HIGHWAY 75 STE 300
Mailing Address - Street 2:ATTN BILLING
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4589
Mailing Address - Country:US
Mailing Address - Phone:903-416-6260
Mailing Address - Fax:
Practice Address - Street 1:5012 S US HIGHWAY 75 STE 210
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4590
Practice Address - Country:US
Practice Address - Phone:903-416-6260
Practice Address - Fax:903-416-6261
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2669207VG0400X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122996502Medicaid
OK100162590AMedicaid
TX85Y242Medicare PIN
TX122996502Medicaid