Provider Demographics
NPI:1154801991
Name:PARMENTER, PAUL (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:PARMENTER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 KINGS RD APT 1159
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-7417
Mailing Address - Country:US
Mailing Address - Phone:605-209-8351
Mailing Address - Fax:
Practice Address - Street 1:1215 KINWEST PKWY # 110
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3403
Practice Address - Country:US
Practice Address - Phone:972-506-0931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1310102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist