Provider Demographics
NPI:1295171452
Name:SCOTT, MARK ALAN JR (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:SCOTT
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 ACCENT DR
Mailing Address - Street 2:# 2223
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3930 ACCENT DR
Practice Address - Street 2:# 2223
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7713
Practice Address - Country:US
Practice Address - Phone:214-403-5762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor