Individual provider Active NPI

Charles Davis Parks, RPH

  • Pharmacist
  • Dallas, TX
National Provider Identifier
1790120665
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25396 Issued in TX
Practice address
2603 Oak Lawn Ave
Dallas, TX 75219-4021
Phone
(214) 394-8644
Fax
(214) 206-9073
NPI assigned
May 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25396 TX Primary

Addresses

Primary practice location

2603 Oak Lawn Ave
Dallas, TX 75219-4021

Mailing address

2633 McKinney Ave # 130-240
Dallas, TX 75204-2581
Phone (214) 394-8644

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
25396TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Trilogy Pharmacy Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1790120665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 MCKINNEY AVE # 130-240",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042581",
            "telephone_number": "214-394-8644",
            "fax_number": "214-206-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 OAK LAWN AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194021",
            "telephone_number": "214-394-8644",
            "fax_number": "214-206-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "CHARLES",
        "middle_name": "DAVIS",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "25396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.