Douglas S. Park M.D. PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

F6298 Issued in TX

Legal business name

DOUGLAS S. PARK M.D. PA

Practice address

705 W. Wadley
Midland, TX 79705-5373

Phone

(432) 687-4044

Fax

(432) 687-0528

NPI assigned

Nov 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Douglas S. Park, M.D.

Title

Owner

Phone

(432) 687-4044

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1760635874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W. WADLEY",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797055373",
            "telephone_number": "432-687-4044",
            "fax_number": "432-687-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W. WADLEY",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797055373",
            "telephone_number": "432-687-4044",
            "fax_number": "432-687-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS S. PARK M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "432-687-4044",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "F6298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00395X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131459306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ramon G Doria, REGISTERED NURSE
• Milouse Dornevil
• Erika Lenora Dorsey
• Pamela Floyd Doughty
• Douglas Park I LTD
• Caroline Elizabeth Downing, MS,RD,LD
• Dr Donald J Ammon Jr DC PLLC
• Dr. James W. Carpenter, O.D.
• Dr. Pepermintwala PLLC
• Ella Drablos

• Specialist in Midland, TX
• Providers in Midland, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.