Provider Demographics
NPI:1265496426
Name:KROCK, MARC D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:D
Last Name:KROCK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4510 MEDICAL CENTER DR.
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-6174
Mailing Address - Country:US
Mailing Address - Phone:469-440-2570
Mailing Address - Fax:214-548-5667
Practice Address - Street 1:4510 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 209
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1650
Practice Address - Country:US
Practice Address - Phone:469-440-2570
Practice Address - Fax:214-548-5667
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2017-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM1849207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177280801Medicaid
TX177280801Medicaid
TXH74949Medicare UPIN