Active NPI
Mark Conrad, D.O.
- Family Medicine Physician
- Garland, TX
National Provider Identifier
1265810691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO2502
- Practice address
- 601 Clara Barton Blvd
Suite 340
Garland, TX 75042-5738 - Phone
- (469) 800-2260
- NPI assigned
- May 18, 2015
- Last updated
- Sep 16, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 13
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R8878 | TX | |
| Family Medicine Physician | 207Q00000X | E-11892 | AR | |
| Family Medicine Physician | 207Q00000X | 15482 | ND | |
| Family Medicine Physician | 207Q00000X | 6550 | OK | |
| Family Medicine Physician | 207Q00000X | 2019000361 | MO | |
| Family Medicine Physician | 207Q00000X | 312293 | LA | |
| Family Medicine Physician | 207Q00000X | DO.2059 | AL | |
| Family Medicine Physician | 207Q00000X | MED-PHYS-LIC-78315 | MT | |
| Family Medicine Physician | 207Q00000X | 11418132-1204 | UT | |
| Family Medicine Physician | 207Q00000X | H88113 | MD | |
| Family Medicine Physician | 207Q00000X | DO2975 | ME | |
| Family Medicine Physician | 207Q00000X | 008193 | AZ | |
| Family Medicine Physician | 207Q00000X | DO2502 | NV | Primary |
Addresses
Primary practice location
601 Clara Barton Blvd
Suite 340
Garland, TX 75042-5738
Mailing address
601 Clara Barton Blvd
Suite 340
Garland, TX 75042-5738
Phone (469) 800-2260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO.2059 | AL | MD | Family Medicine Physician |
| E-11892 | AR | MD | Family Medicine Physician |
| 008193 | AZ | MD | Family Medicine Physician |
| 312293 | LA | MD | Family Medicine Physician |
| H88113 | MD | MD | Family Medicine Physician |
| DO2975 | ME | MD | Family Medicine Physician |
| 2019000361 | MO | MD | Family Medicine Physician |
| MED-PHYS-LIC-78315 | MT | MD | Family Medicine Physician |
| 15482 | ND | MD | Family Medicine Physician |
| DO2502 | NV | MD | Family Medicine Physician |
| R8878 | TX | MD | Family Medicine Physician |
| 11418132-1204 | UT | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568592000000",
"number": "1265810691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 CLARA BARTON BLVD",
"address_2": "SUITE 340",
"city": "GARLAND",
"state": "TX",
"postal_code": "750425738",
"telephone_number": "469-800-2260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 CLARA BARTON BLVD",
"address_2": "SUITE 340",
"city": "GARLAND",
"state": "TX",
"postal_code": "750425738",
"telephone_number": "469-800-2260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONRAD",
"first_name": "MARK",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-18",
"last_updated": "2019-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "R8878",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E-11892",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ND",
"license": "15482",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "6550",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2019000361",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "312293",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "DO.2059",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MT",
"license": "MED-PHYS-LIC-78315",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "11418132-1204",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "H88113",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "DO2975",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "008193",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "DO2502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Garland, TX
- Comp Derma, PLLC (Howsden Dermatology)
- Comprehensive Breast Care Center of Texas, Inc (Solis Women's Health)
- Comprehensive Dermatology, P.a. (Howsden Dermatology)
- Concentra Health Services, Inc.
- Curt Conrad, D.D.S
- Mary G. Conrad, N.P.
- Content Assisted Living Home LLC
- Philip Lynn Cook, D.C.
- Valane Conrad Cook, DMD
- Vernon Cook
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.