Provider Demographics
NPI:1245719699
Name:PARKS, ASHLEY BROOKE (CPR/FIRST AIDE)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:BROOKE
Last Name:PARKS
Suffix:
Gender:F
Credentials:CPR/FIRST AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 W I 40 STE 110
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2518
Mailing Address - Country:US
Mailing Address - Phone:806-353-2700
Mailing Address - Fax:
Practice Address - Street 1:6300 W I 40 STE 110
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2518
Practice Address - Country:US
Practice Address - Phone:806-353-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3747P1801XMedicaid