Provider Demographics
NPI:1881025179
Name:MCFAUL, MARK
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:MCFAUL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7070 W CAMP WISDOM RD APT 422
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75236-5611
Mailing Address - Country:US
Mailing Address - Phone:214-333-5502
Mailing Address - Fax:214-333-5382
Practice Address - Street 1:7070 W CAMP WISDOM RD APT 422
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75236-5611
Practice Address - Country:US
Practice Address - Phone:214-333-5502
Practice Address - Fax:214-333-5382
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health