Asmussen, Mark Dwayne
Asmussen, Mark Dwayne is an individual health care provider with primary practice located at 600 N Park St , Brenham TX 77833-2610. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Asmussen, Mark Dwayne can be contacted via phone (979) 836-6153.Contact Information
Primary practice address
600 N Park St
Brenham TX 77833-2610
Phone: (979) 836-6153
Fax: (979) 277-9074
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA07059 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA07059 | Texas |
Profile Details
| NPI number | 1134427602 |
|---|---|
| LBN Legal business name | Asmussen, Mark Dwayne |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 8th, 2011 |
| Last updated | Sep 4th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134427602 | NPPES |
| Texas | Other | PA07059 | TEXAS STATE LICENSE |
| Texas | MEDICAID | 309349401 | TEXAS STATE LICENSE |
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