Healthcare Provider Details

I. General information

NPI: 1083840375
Provider Name (Legal Business Name): MAREK WALCZAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 DIMMITT RD
PLAINVIEW TX
79072-1833
US

IV. Provider business mailing address

1781 SPYGLASS DR APT 246
AUSTIN TX
78746-6890
US

V. Phone/Fax

Practice location:
  • Phone: 806-296-5531
  • Fax:
Mailing address:
  • Phone: 203-906-5389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberN0537
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN0537
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: