Individual
MR. RICHARD W PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST
Contact information
Practice address
1301 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2122
(817) 882-2000
Mailing address
PO BOX 11219, FORT WORTH, TX 76110-0219
(817) 294-7444
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88460
CERTIFIED SURGICAL TECHNO
TX
Enumeration date
08/16/2006
Last updated
07/08/2007
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