1609198852 NPI number — MR. MARK ALLAN AHRENS D.C.

Table of content: MR. MARK ALLAN AHRENS D.C. (NPI 1609198852)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609198852 NPI number — MR. MARK ALLAN AHRENS D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHRENS
Provider First Name:
MARK
Provider Middle Name:
ALLAN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609198852
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2913 CORPORATE CIR
Provider Second Line Business Mailing Address:
STE 400
Provider Business Mailing Address City Name:
FLOWER MOUND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75028-5616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-470-6774
Provider Business Mailing Address Fax Number:
972-692-7280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3305 LONG PRAIRIE RD
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
FLOWER MOUND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75022-2702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-470-6774
Provider Business Practice Location Address Fax Number:
972-724-2049
Provider Enumeration Date:
02/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  12129 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: TXB164271 . This is a "MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 608755 . This is a "BLUE CROSS BLUE SHEILD RECORD ID" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com