DR. MARK A HACKBARTH (NPI# 1629071527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629071527 |
| Entity Type | Individual |
| Full Name | DR. MARK A HACKBARTH |
| Credential | MD |
| Practice Address |
2737 S Broadway Ave Tyler TX 75701 |
| Mailing Address |
Po Box 6605 Tyler TX 75711-6605 |
| Practice Telephone | 9035926000 |
| Practice Fax Number | 9035923224 |
| Mailing Telephone | 9035926000 |
| Mailing Fax Number | 9035923224 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2019-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
G3420 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1814 Roseland Blvd, Second Floor, Suite 200, Tyler, TX 757014234 | 9035312500 | 9035953785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568476083 | Mark Daniel Hackbarth | Dentist | 12770 W North Ave, Brookfield, WI 53005-4628 | 2006-07-28 |
| Street Address |
2737 S BROADWAY AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194216994 | Leslie Karen Partlow | Nurse Practitioner | 2737 S Broadway Ave, Tyler, TX 75701-5413 | 2018-05-29 |
| 1134633266 | Wendy Prewett | Nurse Practitioner | 2737 S Broadway Ave, Tyler, TX 75701-5413 | 2017-11-28 |
| 1871044115 | Travis Squyres | Nurse Practitioner | 2737 S Broadway Ave, Tyler, TX 75701 | 2016-10-21 |
| 1881076891 | Preston Harmon | Emergency Medicine | 2737 S Broadway Ave, Tyler, TX 75701-5413 | 2015-06-25 |
| 1427447580 | Ruben Benjamin Delarosa | Physician Assistant | 2737 S Broadway Ave, Tyler, TX 75701 | 2015-01-13 |
| 1346670726 | Charles R Gordon Md Pa | Pharmacy | 2737 S Broadway Ave, Tyler, TX 75701-5413 | 2013-11-20 |
| 1437581055 | Edward Lee Poe | Counselor | 2737 S Broadway Ave, Suite 206, Tyler, TX 75701-5413 | 2013-08-06 |
| 1265670749 | Ellisiv Lien | Physical Medicine & Rehabilitation | 2737 S Broadway Ave, Tyler, TX 75701-5413 | 2009-01-22 |
| 1023276466 | James Alan Muns | Neurological Surgery | 2737 S Broadway Ave, Tyler, TX 75701-5413 | 2008-05-31 |
| 1831373042 | Andy Juney Redmond | Neurological Surgery | 2737 S Broadway Ave, Tyler, TX 75701-5413 | 2007-12-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679057608 | Rosenfield & Wenrich, Pllc | Anesthesiology | 6115 New Copeland Road, Tyler, TX 75703-6360 | 2018-09-15 |
| 1982717955 | Charles R Gordon Md Pa | Anesthesiology | 2737 S Broadway Ave Ste 200, Tyler, TX 75701-5445 | 2006-08-16 |
| 1790794121 | Interventional Spine Associates Pa | Anesthesiology | 700 Olympic Plaza Cir Ste 404, Tyler, TX 75701-1952 | 2006-08-05 |
| 1033112933 | Robert M Sutherland | Anesthesiology | 700 Olympic Plaza Cir, Ste 404, Tyler, TX 75701-1955 | 2005-05-24 |
| 1831291723 | Aaron K Calodney M.d., P.a. | Anesthesiology | 1814 Roseland Blvd, #200, Tyler, TX 75701-4234 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033930 | Phuong Dinh Nguyen | Anesthesiology | 11726 E Streamertail Cir # 2, Cypress, TX 77433-6732 | 2020-11-08 |
| 1699375576 | Prwcswtx LLC | Anesthesiology | 700 Paredes Ave Ste 107, Brownsville, TX 78521-2169 | 2020-10-29 |
| 1235742388 | Tricity Pain Associates Pa | Anesthesiology | 14800 San Pedro Ave Ste 115, San Antonio, TX 78232-3734 | 2020-08-28 |
| 1669081915 | Laila Pm&a Group Inc | Anesthesiology | 1803 Longwood Ct, Allen, TX 75013-3074 | 2020-07-23 |
| 1164050498 | Manuel Ybarra Md | Anesthesiology | 255 E Sonterra Blvd Ste 203, San Antonio, TX 78258-4076 | 2020-03-31 |
| 1104451079 | Daniel Dalton Dubose, Md, Pa | Anesthesiology | 201 Crown Pointe Blvd Ste 200, Willow Park, TX 76087-1304 | 2020-03-11 |
| 1700423738 | Esplanade Medical Services Pllc | Anesthesiology | 2024 W 15th St # F-366, Plano, TX 75075-7363 | 2019-12-10 |
| 1760027700 | Sameer Syed, Md, Pa | Anesthesiology | 3151 W 15th St Ste B, Plano, TX 75075-7731 | 2019-11-13 |
| 1518501030 | Institute of Precision Pain Medicine, Pllc | Anesthesiology | 13725 Northwest Blvd Ste 120a, Corpus Christi, TX 78410-3743 | 2019-10-29 |
| 1629628672 | Yancey Pain & Spine, Lllp | Anesthesiology | 9200 Pinecroft Dr Ste 330, Shenandoah, TX 77380-3279 | 2019-09-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.