Provider Demographics
NPI:1962599308
Name:PARKER-GASPARD, EVELYN (PHD)
Entity type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:PARKER-GASPARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 DEMOCRACY DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3687
Mailing Address - Country:US
Mailing Address - Phone:972-403-1359
Mailing Address - Fax:972-403-1378
Practice Address - Street 1:5601 DEMOCRACY DR
Practice Address - Street 2:SUITE 225
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3687
Practice Address - Country:US
Practice Address - Phone:972-403-1359
Practice Address - Fax:972-403-1378
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3-1602103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86755AOtherBCBS
TX154118702Medicaid
TX154118702Medicaid