Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jericho Bryan Park, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1447745179

Dr. Jericho Bryan Park, MD is a Student in an Organized Health Care Education/Training Program in Fort Worth, Texas. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone: (817) 250-2000
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1447745179
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 26, 2018
Last updated in NPPESMarch 27, 2024
Certification dateMarch 27, 2024
Mailing address1301 Pennsylvania Ave, Fort Worth, TX 76104-2122

Other providers in Fort Worth