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NPI Code Detail

MEDICARE: DR. MARK A DIRNBERGER D.O.,P.A.

MEDICARE: DR. MARK A DIRNBERGER D.O.,P.A.
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
1208VP0000XPain Medicine PhysicianL5305TX
2204D00000XNeuromusculoskeletal Medicine & OMM PhysicianL5305TX

General Provider Information

NPI Number : 1841366465
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK A DIRNBERGER D.O.,P.A.
Provider Business Mailing Address
First Line : 74 REGENCY PKWY
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-7816
Country : US
Telephone Number : 817-419-6111
Fax Number : 817-419-9582
Provider Business Practice Location Address
First Line : 74 REGENCY PKWY
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-7816
Country : US
Telephone Number : 817-419-6000
Fax Number : 817-419-9582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2006
Last Update Date : 02/14/2024

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