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David Edward Parkus

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NPI Number Detailed Information

Provider Information:

Name: David Edward Parkus
Gender: M
Provider License Number If Given: K4519

NPI Information:

NPI: 1023017613
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 2/23/2012

Provider Business Mailing Address:

Address: 2965 HARRISON ST SUITE 211
Beaumont, TX 77702
Phone Number: 4098998501
Fax Number: 4098998510

Provider Business Practice Location Address:

Address: 2965 HARRISON ST SUITE 211
Beaumont, TX 77702
Phone Number: 4098998501
Fax Number: 4098998510

Provider Taxonomy:

Primary: 208600000X
Secondary (if any): 2086S0127X
State: TX

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