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General NPI Number Information
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NPI Number | 1265810691
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Entity Type | Individual
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Provider Name | MARK CONRAD D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 09/16/2019
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Provider Practice Location Address
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Address Line | 601 CLARA BARTON BLVD SUITE 340
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City | GARLAND
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State | TX
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Zip | 75042-5738
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Country | US
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Telephone | 469-800-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 601 CLARA BARTON BLVD SUITE 340
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City | GARLAND
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State | TX
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Zip | 75042-5738
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Country | US
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Telephone | 469-800-2260
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R8878
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-11892
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 15482
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License Number State | ND
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6550
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2019000361
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License Number State | MO
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 312293
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License Number State | LA
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO.2059
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License Number State | AL
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MED-PHYS-LIC-78315
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License Number State | MT
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11418132-1204
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License Number State | UT
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Taxonomy #10
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H88113
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License Number State | MD
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Taxonomy #11
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO2975
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License Number State | ME
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Taxonomy #12
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 008193
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License Number State | AZ
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Taxonomy #13
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO2502
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License Number State | NV
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