Provider Demographics
NPI:1083104749
Name:DR MARK TROXLER LLC
Entity Type:Organization
Organization Name:DR MARK TROXLER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:TROXLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO MBA FACP FACSM
Authorized Official - Phone:972-369-0739
Mailing Address - Street 1:5056 CASTLE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4066
Mailing Address - Country:US
Mailing Address - Phone:972-369-0739
Mailing Address - Fax:972-369-0726
Practice Address - Street 1:7651 ELDORADO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1735
Practice Address - Country:US
Practice Address - Phone:972-369-0739
Practice Address - Fax:972-369-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9922261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX393249302Medicaid