Provider Demographics
NPI:1699112110
Name:PARKER, SUE ELLEN (BSB/A, CCNT)
Entity type:Individual
Prefix:MRS
First Name:SUE
Middle Name:ELLEN
Last Name:PARKER
Suffix:
Gender:F
Credentials:BSB/A, CCNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12891 CLAREWOOD DR
Mailing Address - Street 2:SAME
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-1755
Mailing Address - Country:US
Mailing Address - Phone:281-677-7212
Mailing Address - Fax:
Practice Address - Street 1:12891 CLAREWOOD DR
Practice Address - Street 2:SAME
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-1755
Practice Address - Country:US
Practice Address - Phone:281-677-7212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care