WILLIE JOE PARKS JR. (NPI# 1306918172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306918172 |
| Entity Type | Individual |
| Full Name | WILLIE JOE PARKS JR. |
| Credential | D.D.S., M.D. |
| Practice Address |
815 S Fleishel Ave Tyler TX 75701-2017 |
| Practice Telephone | 9035267977 |
| Practice Fax Number | 9035267989 |
| Mailing Telephone | 9035267977 |
| Mailing Fax Number | 9035267989 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2011-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
17107 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1113110-02 | 05 | |
| TX | 0808586-01 | 05 | |
| TX | 1113110-03 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396785200 | Willie J Parks | Pediatrics | 5455 Meridian Mark Rd, 530, Atlanta, GA 30342 | 2006-06-08 |
| Street Address |
815 S FLEISHEL AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-2017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497054712 | Will J Parks Dds Md Pa | Dentist | 815 S Fleishel Ave, Tyler, TX 75701-2017 | 2011-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912258740 | Stone Oral Facial Surgery Group Pllc | Dentist | 2550 Elkton Trl, Tyler, TX 75703-0594 | 2012-09-19 |
| 1386874063 | Charles G. Stone, Jr. Dds PC | Dentist | 3100 New Copeland Rd., Tyler, TX 75701 | 2009-07-16 |
| 1851466064 | Stephen James Cosentino | Dentist | 1215 Doctors Drive, Tyler, TX 75701 | 2006-11-22 |
| 1639241599 | Dennis Ross Spence | Dentist | 700 Olympic Plaza Cir Ste 412, Tyler, TX 75701-1952 | 2006-11-15 |
| 1417067497 | Makoto Saigusa | Dentist | 805 Turtle Creek Dr, Tyler, TX 75701-1937 | 2006-08-30 |
| 1841219342 | Charles Glenn Stone Jr. | Dentist | 3100 New Copeland Rd, Tyler, TX 75701-7940 | 2006-07-18 |
| 1447886619 | East Texas Omfs Trauma Consultants, Pllc | Dentist | 2550 Elkton Trl, Tyler, TX 75703-0594 | 2020-03-19 |
| 1740612084 | Wade Ryan Barker | Dentist | 2550 Elkton Trl, Tyler, TX 75703 | 2013-08-08 |
| 1124393434 | Barry G Acker Dds Pa | Dentist | 3100 New Copeland Rd, Tyler, TX 75701-7940 | 2012-03-20 |
| 1497054712 | Will J Parks Dds Md Pa | Dentist | 815 S Fleishel Ave, Tyler, TX 75701-2017 | 2011-03-25 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.