Individual
MARK J HUPERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1124 COLLEGE AVE, FORT WORTH, TX 76104-4557
(817) 348-0821
(817) 348-0073
Mailing address
1125 COLLEGE AVE, FORT WORTH, TX 76104-4514
(817) 348-0821
(817) 348-0073
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
L1619
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146391102
—
TX
01
—
8J8302
BCBS
TX
01
—
P00289085
MEDICARE RAILROAD
—
Enumeration date
02/20/2006
Last updated
01/21/2013
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