Provider Demographics
NPI:1053350611
Name:PARKEY, WENDELL W (MD)
Entity type:Individual
Prefix:
First Name:WENDELL
Middle Name:W
Last Name:PARKEY
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 1:207 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:TX
Mailing Address - Zip Code:79360-3447
Mailing Address - Country:US
Mailing Address - Phone:432-758-1155
Mailing Address - Fax:432-758-4740
Practice Address - Street 1:207 NW 8TH ST
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:TX
Practice Address - Zip Code:79360-3447
Practice Address - Country:US
Practice Address - Phone:432-758-1155
Practice Address - Fax:432-758-4740
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6644207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113556803OtherTEXAS MEDICAID
TX112902OtherSUPERIOR CHIPS OF TEXAS
TX113556804OtherTEXAS MEDICAID HEALTH STEPS
TX121036104OtherFIRSTCARE
TX0051BSOtherBLUE CROSS AND BLUE SHIELD OF TEXAS
TX121036104OtherFIRSTCARE
TX8F2644Medicare PIN