Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | G5332 | TX |
Y | 2084N0402X | Child Neurologist | G5332 | TX |
NPI | 1285727370 |
---|---|
Provider Name | Warren A Marks |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TX 76104-2710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 20/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D42613 | (02) |