Provider Demographics
NPI:1881604882
Name:PARKER, CALVIN RAWLES (MD)
Entity type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:RAWLES
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 1:610 STRICKLAND DR
Mailing Address - Street 2:SUITE 340
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-4786
Mailing Address - Country:US
Mailing Address - Phone:409-670-0044
Mailing Address - Fax:409-670-0007
Practice Address - Street 1:610 STRICKLAND DR
Practice Address - Street 2:SUITE 340
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4786
Practice Address - Country:US
Practice Address - Phone:409-670-0044
Practice Address - Fax:409-670-0007
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1274207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129559405Medicaid
TX82520JMedicare ID - Type Unspecified