| Doctor Name: | MADGE ANN PARKER |
| NPI Number: | 1982866448 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | D2546 |
| Business Practice Address: | 10900 Jeanell Dr Kemp, TX - 751434428 |
| Business Phone Number: | 9034986946 |
| Business Fax Number: | |
| Mailing Address: | 10900 Jeanell Dr, KEMP |
| State: | TX |
| Postal Code: | 751434428 |
| Phone Number: | 9034986946 |
| Fax Number: | |
| NPI Enumeration Date: | 06/26/2008 |
| NPI Last Update Date: | 06/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | D2546 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |