Healthcare Provider Details

I. General information

NPI: 1063936086
Provider Name (Legal Business Name): ECNT FEC PHYSICIANS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 KLAS RD
SHERMAN TX
75092-5959
US

IV. Provider business mailing address

332 KLAS RD
SHERMAN TX
75092-5959
US

V. Phone/Fax

Practice location:
  • Phone: 214-202-0340
  • Fax:
Mailing address:
  • Phone: 214-202-0340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK BRIAN BUCKNER
Title or Position: CHAIRMAN
Credential: MD
Phone: 214-202-0340