Provider Demographics
NPI:1780883793
Name:DAVID A MARKS MD PA
Entity type:Organization
Organization Name:DAVID A MARKS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-424-4220
Mailing Address - Street 1:115 GALLERY CIR
Mailing Address - Street 2:102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3388
Mailing Address - Country:US
Mailing Address - Phone:210-494-4220
Mailing Address - Fax:210-494-4227
Practice Address - Street 1:115 GALLERY CIR
Practice Address - Street 2:102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3388
Practice Address - Country:US
Practice Address - Phone:210-494-4220
Practice Address - Fax:210-494-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6513207RC0200X, 207RS0010X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0097RBOtherBCBS GROUP
00Y671Medicare PIN