Individual ProviderPaul Mark ParkerPhysical Medicine & RehabilitationAllopathic & Osteopathic PhysiciansPractice Address8210 Walnut Hill Ln, Suite 805, Dallas, TX 75231-4405(214) 691-6029PECOS EnrollmentBased on the most recent information from CMS, provider Paul Mark Parker does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1598873192Provider TypeIndividualFull NameParker, Paul MarkTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date8/25/2006Last Updated7/9/2007Contact InformationPractice LocationPractice Address8210 Walnut Hill Ln, Suite 805, Dallas, TX 75231-4405Phone(214) 691-6029Fax(214) 373-6857Mailing LocationMailing Address8210 Walnut Hill Ln, Suite 805, Dallas, TX 75231-4405Phone(214) 691-6029Fax(214) 373-6857Provider TaxonomiesCodeDescriptionLicenseCode208100000XPrimaryDescriptionPhysical Medicine & RehabilitationAllopathic & Osteopathic PhysiciansLicenseF4354TexasProvider IdentifiersIDDescriptionIssuerID2864197007DescriptionOtherIssuerCIGNATexasID4074192DescriptionOtherIssuerAETNATexasID88T400DescriptionOtherIssuerBLUE CROSS BLUE SHIELDTexasID752296732001DescriptionOtherIssuerPRUDENTIALTexas