Healthcare Provider Details

I. General information

NPI: 1528250214
Provider Name (Legal Business Name): MARK A MCQUAID MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 MIDWAY RD SUITE 400
PLANO TX
75093-8138
US

IV. Provider business mailing address

2405 MIDWAY ROAD SUITE 400
PLANO TX
75093
US

V. Phone/Fax

Practice location:
  • Phone: 972-378-5347
  • Fax: 972-378-0916
Mailing address:
  • Phone: 972-378-5347
  • Fax: 972-378-0916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberJ2201
License Number StateTX

VIII. Authorized Official

Name: MARK A MCQUAID
Title or Position: M.D.
Credential: M.D.
Phone: 972-378-5347