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General NPI Number Information
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NPI Number | 1144140153
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Entity Type | Individual
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Provider Name | MARC MINTZ RPH
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Gender | Male
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 4128 BRIARBEND RD
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City | DALLAS
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State | TX
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Zip | 75287-3903
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Country | US
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Telephone | 972-981-8053
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Fax | 972-981-8020
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Provider Business Mailing Address
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Address Line | 4128 BRIARBEND RD
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City | DALLAS
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State | TX
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Zip | 75287-3903
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Country | US
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Telephone | 972-981-8053
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Fax | 972-981-8020
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 36290
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License Number State | TX
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