Provider Demographics
NPI:1205986825
Name:LESSNER, MARK ANDREW (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ANDREW
Last Name:LESSNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14660 STATE HIGHWAY 121 STE 100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4630
Mailing Address - Country:US
Mailing Address - Phone:214-705-6611
Mailing Address - Fax:214-619-1007
Practice Address - Street 1:14660 STATE HIGHWAY 121 STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-4630
Practice Address - Country:US
Practice Address - Phone:214-705-6611
Practice Address - Fax:214-619-1007
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS94-06192207X00000X
TXN5187207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX215348803Medicaid
TX215348801Medicaid
TX215348802Medicaid
TX215348805Medicaid
TX215348805Medicaid
TX215348801Medicaid