Provider Demographics
NPI:1114918349
Name:MARKS, LIANNE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LIANNE
Middle Name:
Last Name:MARKS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 WADSWORTH BLVD # 127-3150
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-1550
Mailing Address - Country:US
Mailing Address - Phone:512-543-2326
Mailing Address - Fax:
Practice Address - Street 1:98 WADSWORTH BLVD # 127-3150
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1550
Practice Address - Country:US
Practice Address - Phone:720-580-4893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-05
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10016831207R00000X
COCDRH.0058867207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOTH000Medicare UPIN