Provider Demographics
NPI:1285797274
Name:PARKS, WILLIAM BARTO (MD)
Entity type:Individual
Prefix:PROF
First Name:WILLIAM
Middle Name:BARTO
Last Name:PARKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9250 PINECROFT DR
Mailing Address - Street 2:ADM.
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3218
Mailing Address - Country:US
Mailing Address - Phone:281-364-2587
Mailing Address - Fax:281-364-5875
Practice Address - Street 1:9250 PINECROFT DR
Practice Address - Street 2:ADM.
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3218
Practice Address - Country:US
Practice Address - Phone:281-364-2587
Practice Address - Fax:281-364-5875
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1303208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG1303OtherTX STATE MEDICAL LICENSE
TXD67515Medicare UPIN