Provider Demographics
NPI:1730246273
Name:MESSER, MARK DALE (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:DALE
Last Name:MESSER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:935 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-5378
Mailing Address - Country:US
Mailing Address - Phone:214-771-3350
Mailing Address - Fax:
Practice Address - Street 1:1200 E BRIN ST
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2938
Practice Address - Country:US
Practice Address - Phone:972-551-8426
Practice Address - Fax:972-551-8053
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM53772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L26013Medicare PIN