Active NPI
Jack Anthony Thomas Parker, MD
- Surgery Physician
- Austin, TX
National Provider Identifier
1619649191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 47321
- Practice address
- 4900 Mueller Blvd
Austin, TX 78723-3051 - Phone
- (512) 324-0000
- NPI assigned
- Oct 2, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 47321 | TX | Primary |
Addresses
Primary practice location
4900 Mueller Blvd
Austin, TX 78723-3051
Mailing address
1601 Trinity St Stop Z0200
Austin, TX 78712-1850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47695 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633132800000",
"number": "1619649191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 TRINITY ST STOP Z0200",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787121850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 MUELLER BLVD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787233051",
"telephone_number": "512-324-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "JACK",
"middle_name": "ANTHONY THOMAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-02",
"last_updated": "2021-10-02",
"certification_date": "2021-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "47321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.