Provider Demographics
NPI:1447564596
Name:MARKOV 2 INC.
Entity Type:Organization
Organization Name:MARKOV 2 INC.
Other - Org Name:DMARK MEDICAL DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:MARKOVICH
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:817-995-3793
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-0150
Mailing Address - Country:US
Mailing Address - Phone:817-995-3793
Mailing Address - Fax:817-563-2409
Practice Address - Street 1:912 TREMONT ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6071
Practice Address - Country:US
Practice Address - Phone:817-995-3793
Practice Address - Fax:817-563-2409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-31
Last Update Date:2010-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1100832261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy