Lisch, Mark S

Lisch, Mark S is an sole proprietor health care provider with primary practice located at 6816 Shadow Creek Ct , Fort Worth TX 76132-4522. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Lisch, Mark S can be contacted via phone (832) 368-6841.

Contact Information

Primary practice address
6816 Shadow Creek Ct Fort Worth TX 76132-4522
Phone: (832) 368-6841
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 0787 Texas

Profile Details

NPI number 1124094958
LBN Legal business name Lisch, Mark S
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 23rd, 2006
Last updated Oct 4th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124094958 NPPES
Texas MEDICAID 085279001
Texas Other 82Y991
Texas MEDICAID 092841802

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