Healthcare Provider Details

I. General information

NPI: 1245088756
Provider Name (Legal Business Name): DAVID JAY MARKSON RSPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 05/09/2024
Certification Date: 05/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 PINECOMB WOODS ST
SAN ANTONIO TX
78249-1828
US

IV. Provider business mailing address

4610 PINECOMB WOODS ST
SAN ANTONIO TX
78249-1828
US

V. Phone/Fax

Practice location:
  • Phone: 210-378-6846
  • Fax:
Mailing address:
  • Phone: 210-378-6846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number1374-1021
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: