Individual
DR. MARK RICHARD BRONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5521 BELLAIRE DR S, SUITE 100, BENBROOK, TX 76109-8838
(817) 732-4441
Mailing address
5521 BELLAIRE DR S, SUITE 100, BENBROOK, TX 76109-8838
(817) 732-4441
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
4065
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001251001
—
TX
01
—
4065
STATE LICENSE
TX
01
—
751839034
TAX ID
TX
Enumeration date
02/15/2006
Last updated
02/20/2020
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