Provider Demographics
NPI:1215069091
Name:PARKER, STEPHEN BRANT (ATC, LAT, MA)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:BRANT
Last Name:PARKER
Suffix:
Gender:M
Credentials:ATC, LAT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GETTYSBURG LN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2301
Mailing Address - Country:US
Mailing Address - Phone:972-437-5995
Mailing Address - Fax:972-437-5995
Practice Address - Street 1:6 GETTYSBURG LN
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2301
Practice Address - Country:US
Practice Address - Phone:972-437-5995
Practice Address - Fax:972-437-5995
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT03552255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer