DR. DOUGLAS S. PARK (NPI# 1386645521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386645521 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS S. PARK |
| Credential | M.D., FACP |
| Practice Address |
705 W. Wadley Ave. Midland TX 79705-5373 |
| Mailing Address |
705 W Wadley Ave Midland TX 79705-5373 |
| Practice Telephone | 4326874044 |
| Practice Fax Number | 4326870528 |
| Mailing Telephone | 4326874044 |
| Mailing Fax Number | 4326870528 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2013-08-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 752636710 | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1314593-06 | 05 | |
| TX | MEDICARE ID | 00F15F | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538205703 | Douglas John Park | Physical Therapist | 2625 Dovershire Rd, Richmond, VA 23235-2815 | 2007-01-29 |
| 1518033711 | Douglas J Park | Psychologist | 6926 Ne Fourth Plain Blvd, Vancouver, WA 98661 | 2006-11-28 |
| 1366521122 | Douglas Lee Park | Dentist | 1201 Se 223rd Ave, Suite 240, Gresham, OR 97030 | 2006-11-03 |
| 1912967019 | Douglas J. Park | Psychologist | 2314 Monroe St, Dearborn, MI 48124-3010 | 2006-03-24 |
| Street Address |
705 W. WADLEY AVE. |
| City | MIDLAND |
| State | TX |
| Zip Code | 79705-5373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949915 | Diyora Amanova | Dentist | 2817-b, Loop 250 Frontage Rd, Midland, TX 79705 | 2020-07-08 |
| 1821610205 | Winners Circle Group of Tx | Community/Behavioral Health | 4405 N Garfield Street, Apt. 1005, Midland, TX 79705 | 2020-05-08 |
| 1619523644 | Lillian Moreno | Physician Assistant | 3600 N Garfield St., Midland, TX 79705 | 2019-08-15 |
| 1689229429 | Michelle Ray | Student in an Organized Health Care Education/Training Program | Texas Tech University Health Science Center, 3600 N. Garfield, Midland, TX 79705 | 2019-08-08 |
| 1649825001 | Marlene Cereceres | Student in an Organized Health Care Education/Training Program | 3600 N. Garfield, Midland, TX 79705 | 2019-08-02 |
| 1194370627 | Brianne Marie Hanson | Student in an Organized Health Care Education/Training Program | 3600 North Garfield, Midland, TX 79705 | 2019-08-01 |
| 1841844685 | Stephanie Ann Johnson | Student in an Organized Health Care Education/Training Program | Texas Tech University Health Sciences Center, 3600 N. Garfield, Midland, TX 79705 | 2019-07-30 |
| 1013560093 | Andrea Silva | Licensed Practical Nurse | 2903 Ncr 1140, Midland, TX 79705 | 2019-07-19 |
| 1417509332 | Ananya Das | Physician Assistant | 3600 North Garfield St., Midland, TX 79705 | 2019-07-11 |
| 1023571767 | Wecare Tlc- Pioneer Mco | Clinic/Center | 3617 N Big Sping, Midland, TX 79705 | 2019-04-10 |
| Find all providers in zip 79705 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447797014 | Dickerson Dallas Pain On Pa | Specialist | 4311 Andrews Hwy, Midland, TX 79703 | 2017-01-20 |
| 1275944886 | Suzanne Marie Barbu | Specialist | 3609 E Monroe Rd, Midland, MI 48642-8835 | 2014-05-16 |
| 1760635874 | Douglas S. Park M.d. Pa | Specialist | 705 W. Wadley, Midland, TX 79705-5373 | 2008-11-03 |
| 1356559041 | Midmichigan Cardiology | Specialist | 111 E Wackerly St, Suite D, Midland, MI 48642-7001 | 2007-05-18 |
| 1417172933 | Harshad G Shah Md Pa Eye Institute | Specialist | 4214 Andrews Hwy Ste 105, Midland, TX 79703-4813 | 2007-04-17 |
| 1669507349 | John R. Howlett Jr. | Specialist | 1002 W Wall St, Midland, TX 79701-6638 | 2007-02-22 |
| 1508936840 | Thomas Charles Turner | Specialist | 805 W Wadley Ave, Midland, TX 79705-6557 | 2006-11-08 |
| 1326145541 | Vikram N Patel, Md Pa | Specialist | 2407 W Louisiana Ave Ste 104, Midland, TX 79701-5826 | 2006-09-20 |
| 1831294446 | Wilbur George Lineback Jr. | Specialist | 2104 W Michigan Ave, Midland, TX 79701-5928 | 2006-09-14 |
| 1699882639 | Lori D. Adcock | Specialist | 303 Veterans Airpark Ln, Suite 4109, Midland, TX 79705-0000 | 2006-08-24 |
| Find all providers in MIDLAND | ||||
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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.