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General NPI Number Information
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NPI Number | 1134435381
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Entity Type | Organization
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Legal Business Name | MARK CWIKLA MD PA
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 405 STATE HIGHWAY 121 BYP BUILDING A STE 150
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City | LEWISVILLE
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State | TX
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Zip | 75067-8214
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Country | US
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Telephone | 972-869-4768
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Fax | 972-254-9640
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Provider Business Mailing Address
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Address Line | 7301 STATE HIGHWAY 161 STE 161
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City | IRVING
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State | TX
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Zip | 75039-2816
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Country | US
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Telephone | 972-259-4768
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Fax |
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Authorized Official
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Title or Position | OFFICE MGR
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Name | NIKI ENDICOTT
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Credential |
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Telephone | 972-869-4768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | F3678
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License Number State | TX
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