Provider Demographics
NPI:1447238415
Name:WORKMAN, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 MAPLEWOOD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-3879
Mailing Address - Country:US
Mailing Address - Phone:940-696-8500
Mailing Address - Fax:940-696-8546
Practice Address - Street 1:4301 MAPLEWOOD AVE STE A
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-3879
Practice Address - Country:US
Practice Address - Phone:940-696-8500
Practice Address - Fax:940-696-8546
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8582207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0418949-01Medicaid
TX0418949-01Medicaid
TX83206JMedicare ID - Type UnspecifiedMEDICARE