Individual
DR. MARK WILLIAM WALBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3410 WORTH ST, DALLAS, TX 75246-2003
(214) 370-1000
(214) 370-1026
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
J6272
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116591201
—
TX
05
—
116591205
—
TX
01
—
116591206
CSHCN
TX
05
—
116591207
—
TX
01
—
8R1578
BLUE CROSS OF TEXAS
TX
Enumeration date
06/03/2006
Last updated
10/26/2011
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