Individual provider Active NPI

Mark S Mlcak, M.D.

  • Family Medicine Physician
  • Garland, TX
National Provider Identifier
1699797936
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G3618 Issued in TX
Practice address
7217 Telecom Pkwy Ste 100
Garland, TX 75044-2203
Phone
(469) 800-2100
Fax
(469) 800-2310
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G3618 TX Primary

Addresses

Primary practice location

7217 Telecom Pkwy Ste 100
Garland, TX 75044-2203

Mailing address

7217 Telecom Pkwy Ste 100
Garland, TX 75044-2203
Phone (469) 800-2100

Other identifiers 2

IdentifierTypeStateIssuer
133740406MedicaidTX
080086246OtherTXRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100429000433 TX Practitioner - Family Practice 5597892299 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G3618TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network CurrentSince Oct 25, 1993 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Oct 25, 1993 Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

601 Clara Barton Blvd
Ste 140
Garland, TX 75042
Phone (972) 272-6561

7217 Telecom Pkwy
Ste 100
Garland, TX 75044
Phone (469) 669-0306

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1699797936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7217 TELECOM PKWY STE 100",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750442203",
            "telephone_number": "469-800-2100",
            "fax_number": "469-800-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7217 TELECOM PKWY STE 100",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750442203",
            "telephone_number": "469-800-2100",
            "fax_number": "469-800-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLCAK",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G3618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133740406",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080086246",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.