Basic Information
| Provider Information | |||||||||
| NPI: | 1306363114 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARKER | ||||||||
| FirstName: | CELESTE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | ED.D, BCN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 70 MISSION DR | ||||||||
| Address2: | |||||||||
| City: | NEW BRAUNFELS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781306659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108001111 | ||||||||
| FaxNumber: | 2819250648 | ||||||||
| Practice Location | |||||||||
| Address1: | 70 MISSION DR | ||||||||
| Address2: | |||||||||
| City: | NEW BRAUNFELS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781306659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108001111 | ||||||||
| FaxNumber: | 2819250648 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZE0600X | N | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Electroneurodiagnostic | 2472E0500X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | EEG | 246ZE0500X | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | EEG |
No ID Information.