Individual
LISA D PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
3840 HULEN ST, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76107-7277
(817) 569-4396
(817) 569-4517
Mailing address
PO BOX 2603, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76113-2603
(817) 569-4396
(817) 569-4517
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT07321
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196613701
—
TX
01
—
8X7944
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/30/2007
Last updated
07/15/2009
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