Prince, Mark D

Prince, Mark D is an individual health care provider with primary practice located at 910 E Houston St Ste 470 , Tyler TX 75702-8365. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Prince, Mark D can be contacted via phone (903) 510-8718.

Contact Information

Primary practice address
910 E Houston St Ste 470 Tyler TX 75702-8365
Phone: (903) 510-8718
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 35969 Tennessee
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X P8720 Texas

Profile Details

NPI number 1629061171
LBN Legal business name Prince, Mark D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Mar 19th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629061171 NPPES
Texas Other P01812747 RAIL ROAD MEDICARE
Texas Other 75-2616977-054 RAIL ROAD MEDICARE
Texas MEDICAID 338983501 RAIL ROAD MEDICARE
Texas MEDICAID 338983502 RAIL ROAD MEDICARE

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