Provider Demographics
NPI:1285727370
Name:MARKS, WARREN A (MD)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:A
Last Name:MARKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:1500 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2710
Practice Address - Country:US
Practice Address - Phone:682-885-2500
Practice Address - Fax:682-885-2510
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5332208000000X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6325480OtherCIGNA PIN
TX108902OtherSUPERIOR PIN
TX118572100OtherFIRSTCARE PIN
TX140442803Medicaid
TX4092530OtherAETNA PIN
TX1640410OtherFIRSTHEALTH PIN
TX10028602OtherAMERIGROUP PIN
TX137786304Medicaid
1750369203OtherGRP NPI NUMBER
TX137786305Medicaid
TX1392932OtherUHC PIN
TX413481OtherPHCS PIN
TX87V781OtherBCBSTX IND PIN
TX00U87ZOtherBCBSTX GRP PIN
TX023247201Medicaid
TX413481OtherPHCS PIN
1750369203OtherGRP NPI NUMBER
TX140442803Medicaid