Individual
PADGETT PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10799
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1L4707
MEDICARE
TX
05
—
366673702
—
TX
01
—
P02601774
MCRR
TX
Enumeration date
12/13/2016
Last updated
08/25/2022
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