Provider Demographics
NPI:1285728766
Name:PARKER, EHRIN E (DO)
Entity type:Individual
Prefix:
First Name:EHRIN
Middle Name:E
Last Name:PARKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 OLD WEST DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-7452
Mailing Address - Country:US
Mailing Address - Phone:512-255-3631
Mailing Address - Fax:512-255-3972
Practice Address - Street 1:405 OLD WEST DRIVE
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-7452
Practice Address - Country:US
Practice Address - Phone:512-255-3631
Practice Address - Fax:512-255-3972
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0097DPOtherBLUE CROSS
TX0097DPOtherBLUE CROSS
TX00510JMedicare ID - Type UnspecifiedMEDICARE