Provider Demographics
NPI:1073778288
Name:MARKOVICH, DAVID GEORGE JR (PT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GEORGE
Last Name:MARKOVICH
Suffix:JR
Gender:M
Credentials:PT
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Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-0150
Mailing Address - Country:US
Mailing Address - Phone:817-995-3793
Mailing Address - Fax:817-563-2409
Practice Address - Street 1:811 W INTERSTATE 20
Practice Address - Street 2:SUITE 136
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5870
Practice Address - Country:US
Practice Address - Phone:817-995-3793
Practice Address - Fax:817-563-2409
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2012-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1100832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L22830Medicare PIN