Individual
THOMAS J PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14131 MIDWAY RD, SUITE 620, ADDISON, TX 75001-3623
(972) 249-0200
(972) 249-0206
Mailing address
14131 MIDWAY RD, SUITE 620, ADDISON, TX 75001-3623
(972) 249-0200
(972) 249-0206
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
23284
AZ
208100000X
Physical Medicine & Rehabilitation Physician
Primary
P7017
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G850000
MEDICARE OF N CA
CA
01
—
250008547
RR MEDICARE
AZ
05
—
403387
—
AZ
01
—
AZ0818870
BC/BS OF AZ
AZ
01
—
Z21067
MEDICARE PROV #
AZ
Enumeration date
11/04/2005
Last updated
07/23/2013
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