Statler, Mark Douglas

Statler, Mark Douglas is an individual health care provider with primary practice located at 1535 E Common St , New Braunfels TX 78130-3154. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Statler, Mark Douglas can be contacted via phone (830) 625-9153.

Contact Information

Primary practice address
1535 E Common St New Braunfels TX 78130-3154
Phone: (830) 625-9153
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G3815 Texas

Profile Details

NPI number 1164475604
LBN Legal business name Statler, Mark Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Aug 3rd, 2011 - about 15 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 1164475604 NPPES
Texas MEDICAID 121490001

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