Provider Demographics
NPI:1467469148
Name:SCHWARTZ, MARK I (OD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:I
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6509 PRECINCT LINE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-4313
Mailing Address - Country:US
Mailing Address - Phone:817-788-2020
Mailing Address - Fax:817-788-2023
Practice Address - Street 1:6509 PRECINCT LINE RD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4313
Practice Address - Country:US
Practice Address - Phone:817-788-2020
Practice Address - Fax:817-788-2023
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3091TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT15793Medicare UPIN
TX83867EMedicare PIN