Provider Demographics
NPI:1730843939
Name:PARKER, DESIE (CPNP)
Entity type:Individual
Prefix:
First Name:DESIE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:DESIE
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4499 MEDICAL DR STE 347
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3853
Mailing Address - Country:US
Mailing Address - Phone:210-615-8757
Mailing Address - Fax:
Practice Address - Street 1:4499 MEDICAL DR STE 347
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3853
Practice Address - Country:US
Practice Address - Phone:210-615-8757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1050032363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics