Individual
MARK RAYMOND ETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5201 HARRY HINES BLVD, HOUSE STAFF & GME, DALLAS, TX 75235-7708
(214) 590-8058
Mailing address
4100 INTERNATIONAL PLAZA, 600, FORT WORTH, TX 76109-4823
(817) 529-1923
(817) 877-0350
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
N8184
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP2-0026701
INSTITUTIONAL PERMIT
—
Enumeration date
06/05/2007
Last updated
07/07/2011
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