Provider Demographics
NPI:1124367305
Name:PARKS CANNON, TERRI (MD)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:PARKS CANNON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16100 SOUTH FWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1895
Mailing Address - Country:US
Mailing Address - Phone:281-929-6184
Mailing Address - Fax:
Practice Address - Street 1:16100 SOUTH FWY
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1895
Practice Address - Country:US
Practice Address - Phone:713-413-6941
Practice Address - Fax:713-413-6554
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5445208M00000X, 207R00000X
GA080913207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine