Individual
STACY LYNNE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2110 W SLAUGHTER LN STE 185, AUSTIN, TX 78748-5992
(512) 647-6049
(361) 413-0274
Mailing address
277 BUDDY GANEM DR STE A, PORTLAND, TX 78374-3202
(361) 777-3900
(361) 413-0274
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA06892
TX
Other
Enumeration date
09/24/2009
Last updated
02/20/2020
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