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General NPI Number Information
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NPI Number | 1164405270
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Entity Type | Individual
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Provider Name | MARK L SHAPIRO M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 2800 E BROAD ST STE 421
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City | MANSFIELD
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State | TX
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Zip | 76063-6415
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Country | US
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Telephone | 469-695-2028
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Fax | 469-695-2029
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Provider Business Mailing Address
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Address Line | 2800 E BROAD ST STE 421
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City | MANSFIELD
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State | TX
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Zip | 76063-6415
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Country | US
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Telephone | 469-695-2028
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Fax | 469-695-2029
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MC-0787
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 219511
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD23567
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2006-01252
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD61612669
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | V4068
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | EMC0000656
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License Number State | MI
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