Healthcare Provider Details

I. General information

NPI: 1295831535
Provider Name (Legal Business Name): GEORGE MICHAEL MARKUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 W CAMPBELL RD STE 304
RICHARDSON TX
75080-3620
US

IV. Provider business mailing address

399 W CAMPBELL RD STE 304
RICHARDSON TX
75080-3620
US

V. Phone/Fax

Practice location:
  • Phone: 972-235-2304
  • Fax: 972-235-8442
Mailing address:
  • Phone: 972-235-2304
  • Fax: 972-235-8442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberF6905
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: