Individual provider Active NPI

Deborah A Parker, PH.D

  • Clinical Child & Adolescent Psychologist
  • Plano, TX
National Provider Identifier
1962478958
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
23569 Issued in TX
Practice address
4031 W Plano Pkwy
Ste 213
Plano, TX 75093-5631
Phone
(972) 599-1953
Fax
(972) 675-3989
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 23569 TX
Counseling Psychologist 103TC1900X 23569 TX
Clinical Child & Adolescent Psychologist 103TC2200X 23569 TX Primary

Addresses

Primary practice location

4031 W Plano Pkwy
Ste 213
Plano, TX 75093-5631

Mailing address

4031 W Plano Pkwy
Suite 213
Plano, TX 75093-5619
Phone (972) 599-1953

Other identifiers 2

IdentifierTypeStateIssuer
032705801MedicaidTX
PARKE-0006OtherTXCOMPCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120629000192 TX Practitioner - Clinical Psychologist 5496910226 Practice locations: Plano, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4031 W Plano Pkwy
Plano, TX 75093-5631
Phone (972) 599-1953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
23569TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1962478958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 W PLANO PKWY",
            "address_2": "SUITE 213",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935619",
            "telephone_number": "972-599-1953",
            "fax_number": "972-675-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 W PLANO PKWY",
            "address_2": "STE 213",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935631",
            "telephone_number": "972-599-1953",
            "fax_number": "972-675-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TX",
            "license": "23569",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "23569",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "23569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032705801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPCARE",
            "identifier": "PARKE-0006",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.