Provider Demographics
NPI:1952966475
Name:MARK9HEALTH PLLC
Entity Type:Organization
Organization Name:MARK9HEALTH PLLC
Other - Org Name:MARK9 PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOEMEKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-325-2005
Mailing Address - Street 1:165 E. STATE HIGHWAY 121, SUITE 110
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-7908
Mailing Address - Country:US
Mailing Address - Phone:972-325-2005
Mailing Address - Fax:972-325-4175
Practice Address - Street 1:165 E. STATE HIGHWAY 121, SUITE 110
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-7908
Practice Address - Country:US
Practice Address - Phone:972-325-2005
Practice Address - Fax:972-325-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty