Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G8110 | TX |
N | 111NI0900X | Internist | G8110 | TX |
Y | 207RG0300X | Geriatric Medicine | G8110 | TX |
NPI | 1083652986 |
---|---|
Provider Name | Mark J Fleschler |
First Address | Dallas, TX 75231-4491 |
Second Address | Dallas, TX 75231-4491 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 15/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
089501301 | (05) | TX |
B22723 | (02) | TX |