Individual
MARK D D'ALISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3502 9TH ST STE 440, LUBBOCK, TX 79415-3368
(806) 761-0535
Mailing address
5219 CITY BANK PKWY STE 35, LUBBOCK, TX 79407-3545
(806) 761-0333
(806) 782-0097
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
J8979
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125356907
—
TX
01
—
335026YKT8
MEDICARE
TX
01
—
8FM001
BCBS
TX
Enumeration date
04/11/2006
Last updated
06/11/2025
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