Organization
DIAGNOSTIC IMAGINING SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY K PARKER M.D. (CHIEF OPERATING OFFICER)
(832) 618-9046
Entity
Organization
Contact information
Practice address
2323 E. HWY 35, ANGLETON, TX 77515-3804
(979) 849-2738
(979) 849-3625
Mailing address
2323 E. HWY 35, ANGLETON, TX 77515
(979) 849-2738
(979) 849-3625
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074AK
BCBS
TX
05
—
081089701
—
TX
Enumeration date
07/02/2006
Last updated
11/25/2009
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