Provider Demographics
NPI:1053551275
Name:MICHAEL P. PARKER, M.D., P.A.
Entity type:Organization
Organization Name:MICHAEL P. PARKER, M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-617-7100
Mailing Address - Street 1:119 S HIGHWAY 342 STE 401
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-6406
Mailing Address - Country:US
Mailing Address - Phone:972-617-7100
Mailing Address - Fax:
Practice Address - Street 1:119 S HIGHWAY 342 STE 401
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-6406
Practice Address - Country:US
Practice Address - Phone:972-617-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-27
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3049261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A3799Medicare PIN