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NPI Code Detail

MEDICARE: DR. MARK A HACKBARTH MD

MEDICARE: DR. MARK A HACKBARTH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) PhysicianG3420TX
2207LA0401XAddiction Medicine (Anesthesiology) PhysicianG3420TX

General Provider Information

NPI Number : 1629071527
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK A HACKBARTH MD
Provider Business Mailing Address
First Line : 300 WILSON ST
Second Line :
City : HENDERSON
State : TX
Zip : 75652-5956
Country : US
Telephone Number : 903-655-6536
Fax Number :
Provider Business Practice Location Address
First Line : 300 WILSON ST
Second Line :
City : HENDERSON
State : TX
Zip : 75652-5956
Country : US
Telephone Number : 903-655-6536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/14/2025

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