Healthcare Provider Details

I. General information

NPI: 1174622740
Provider Name (Legal Business Name): MARK ALLEN ESCHE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 PARKSTONE HEIGHTS DR STE 360
AUSTIN TX
78746-7482
US

IV. Provider business mailing address

4101 PARKSTONE HEIGHTS DR STE 360
AUSTIN TX
78746-7482
US

V. Phone/Fax

Practice location:
  • Phone: 512-637-9551
  • Fax: 512-340-0096
Mailing address:
  • Phone: 512-637-9090
  • Fax: 512-340-0096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberL3636
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: