Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 8311 | TX |
NPI | 1356376248 |
---|---|
Provider Name | Dr. Mark Robert Marquardt |
First Address | Spring, TX 77386-1453 |
Second Address | Spring, TX 77386-1453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 02/11/2007 |