Provider Demographics
NPI:1932109600
Name:TOUPS, DWIGHT MARK (MD,FACP)
Entity Type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:MARK
Last Name:TOUPS
Suffix:
Gender:M
Credentials:MD,FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:919 HIDDEN RDG
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3813
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-0996
Practice Address - Street 1:3030 NORTH ST
Practice Address - Street 2:SUITE 420
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1433
Practice Address - Country:US
Practice Address - Phone:409-835-2900
Practice Address - Fax:409-835-1350
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8972207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1K0613OtherMEDICARE
TX115203504Medicaid
TXTXB152964Medicare PIN