Provider Demographics
NPI:1881261501
Name:TOLIVER, PARKER ANSON (DC)
Entity type:Individual
Prefix:DR
First Name:PARKER
Middle Name:ANSON
Last Name:TOLIVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 KINGS ROW
Mailing Address - Street 2:
Mailing Address - City:MALAKOFF
Mailing Address - State:TX
Mailing Address - Zip Code:75148-9360
Mailing Address - Country:US
Mailing Address - Phone:972-754-1143
Mailing Address - Fax:
Practice Address - Street 1:314 S SHADY SHORES DR STE 100
Practice Address - Street 2:
Practice Address - City:LAKE DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75065-3609
Practice Address - Country:US
Practice Address - Phone:972-754-1143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14528111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation