Healthcare Provider Details

I. General information

NPI: 1043212707
Provider Name (Legal Business Name): ALAN MARK GREENBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 03/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 COIT RD STE 305
FRISCO TX
75035-0509
US

IV. Provider business mailing address

4401 COIT RD STE 305
FRISCO TX
75035-0509
US

V. Phone/Fax

Practice location:
  • Phone: 972-743-6827
  • Fax: 972-469-6807
Mailing address:
  • Phone: 972-743-6827
  • Fax: 972-469-6807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG5115
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: