Provider Demographics
NPI:1497179899
Name:GREENSTEIN, MARK (CO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:GREENSTEIN
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WOODCHUCK LN
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1878
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 SPRING HILL DR
Practice Address - Street 2:SUITE 335
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2381
Practice Address - Country:US
Practice Address - Phone:281-296-8999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist