Provider Information for 1700102613
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MICHELLE DANIELLE PARKER
Sex: Female
NPI: 1700102613
Last Updated: 2023-09-15
Certification Date: 2023-09-15
Certification Date: 2023-09-15
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1700102613 | ||||||||||||
| Enumeration Date | 2010-04-16 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 312 NE 28TH ST OKLAHOMA CITY, OK 73105-2804 United States Phone: 405-245-7368 | Fax:405-231-3157 | ||||||||||||
| Primary Practice Address | 3312 TEASLEY LN STE 100 DENTON, TX 76210-8311 United States Phone: 940-222-2399 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 312 NE 28TH ST | ||||||||||||
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