DR. MARK KOCH (NPI# 1174512651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174512651 |
| Entity Type | Individual |
| Full Name | DR. MARK KOCH |
| Credential | M.D. |
| Practice Address |
1500 S Main St Dept of Family Medicine Fort Worth TX 76104-4917 |
| Mailing Address |
Po Box 911294 Dallas TX 75391-1294 |
| Practice Telephone | 8179271200 |
| Mailing Telephone | 8178528440 |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2016-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | J4274 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376948372 | Mark Ross Koch | Dentist | 521 Edgewater Rd, Pasadena, MD 21122-5633 | 2014-11-03 |
| 1174682041 | Mark G Koch | Marriage & Family Therapist | 1011 N. Main St. #21, White River Junction, VT 05001 | 2006-12-07 |
| 1275176984 | Mark Koch | Physician Assistant | 5656 Kelley St, Houston, TX 77026-1967 | 2019-10-25 |
| 1962532630 | Mark G. Koch | Dentist | 13123 E 16th Ave, B240, Aurora, CO 80045-7106 | 2007-03-06 |
| 1528102647 | Mark Peter Koch | Family Medicine | 33700 Hwy 43, Thomasville, AL 36784-3555 | 2007-02-20 |
| 1699828251 | Mark James Koch | Chiropractor | 1055 Legion Dr, Elm Grove, WI 53122-2202 | 2007-01-18 |
| 1396808622 | Mark Gerald Koch | Marriage & Family Therapist | 2101 Courage Dr, Fairfield, CA 94533-6717 | 2006-12-18 |
| 1326031337 | Mark Koch | Nurse Anesthetist, Certified Registered | 3000 Mack Rd, Fairfield, OH 45014-5335 | 2005-08-24 |
| Street Address |
1500 S MAIN ST DEPT OF FAMILY MEDICINE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518964634 | Akber M Ashraf | Internal Medicine | 1500 S Main St, Fort Worth, TX 76104-4917 | 2005-07-05 |
| 1518567395 | Jordan Loeffelholz | Pediatrics | 1500 S Main St, Fort Worth, TX 76104-4917 | 2020-10-29 |
| 1891305827 | Sandra Bialose | Nurse Practitioner | 1500 S Main St, Fort Worth, TX 76104-4917 | 2020-08-04 |
| 1467060889 | Melissa Godfrey Wood | Nurse Practitioner | 1500 S Main St, Fort Worth, TX 76104-4917 | 2020-07-22 |
| 1053929901 | Brenton C Hall | Pharmacist | 1500 S Main St, Fort Worth, TX 76104-4941 | 2020-07-16 |
| 1952919144 | Chinyere Lilian Nkwocha | Pharmacist | 1500 S Main St, Fort Worth, TX 76104-4917 | 2020-07-14 |
| 1033727227 | Haley Leverett | Pharmacist | 1500 S Main St, Fort Worth, TX 76104-4917 | 2020-07-14 |
| 1447875760 | Lauren Courtney Thompson | Nurse Practitioner | 1500 S Main St, Fort Worth, TX 76104-4917 | 2020-06-12 |
| 1356965883 | Arjun Kulandaivelu | Student in an Organized Health Care Education/Training Program | 1500 S Main St, Fort Worth, TX 76104-4917 | 2020-06-01 |
| 1831710482 | Oliver Taylor | Family Medicine | 1500 S Main St, Fort Worth, TX 76104-4941 | 2020-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184020 | Kara Fenceroy | Family Medicine | 5425 Rolling Meadows Dr, Fort Worth, TX 76123-2836 | 2020-11-03 |
| 1003416207 | Adeline Galvez | Family Medicine | 1300 W Terrell Ave Ste 270, Fort Worth, TX 76104-2820 | 2020-10-27 |
| 1952870354 | Nancy Carolina Nicoloso | Family Medicine | 6302 Lake Worth Blvd Ste A3963, Fort Worth, TX 76135-3607 | 2018-11-15 |
| 1245717586 | Julia Dubose | Family Medicine | 4100 Heritage Trace Pkwy Ste 116, Fort Worth, TX 76244 | 2018-07-19 |
| 1609307115 | Yara Hamade Gonzales | Family Medicine | 4701 Bryant Irvin Rd, Fort Worth, TX 76132-3603 | 2017-03-26 |
| 1558732321 | Andres Morgado Perez | Family Medicine | 1325 Pennsylvania Ave Ste 750, Fort Worth, TX 76104-2168 | 2015-10-19 |
| 1114304805 | Davis Wellness Ltd LLP | Family Medicine | 3750 S. University Dr., Suite 201, Fort Worth, TX 76109-3701 | 2015-05-01 |
| 1902298417 | Jack Lynwood Judson, Md | Family Medicine | 1800 Malibar Rd, Fort Worth, TX 76116-1834 | 2015-02-21 |
| 1104243468 | Henry Dollahite | Family Medicine | 6205 Locke Ave, Fort Worth, TX 76116-4636 | 2014-03-25 |
| 1447676689 | Janet Shackelford | Family Medicine | 5001 Golden Triangle Blvd, # 1024, Fort Worth, TX 76244 | 2014-03-12 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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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.