Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | K4519 | TX |
Y | 208600000X | Surgeon | K4519 | TX |
N | 2086S0127X | Trauma Surgeon | K415 | TX |
N | 2086S0127X | Trauma Surgeon | K4519 | TX |
NPI | 1023017613 |
---|---|
Provider Name | David Edward Parkus |
First Address | Beaumont, TX 77702-1100 |
Second Address | Beaumont, TX 77702-1100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 23/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
835M1 | (05) | TX |
G29910 | (02) | TX |
PO88840JO | (05) | TX |