Allen, Mark
Allen, Mark is an individual health care provider with primary practice located at 4401 Morris Lane , Texarkana TX 75503. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Allen, Mark can be contacted via phone (903) 838-9063.Contact Information
Primary practice address
4401 Morris Lane
Texarkana TX 75503
Phone: (903) 838-9063
Fax: (903) 838-9074
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 05370TG | Texas |
Profile Details
| NPI number | 1245239904 |
|---|---|
| LBN Legal business name | Allen, Mark |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2005 |
| Last updated | Sep 24th, 2012 - about 13 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 | 1245239904 | NPPES |
| Texas | Other | 1285681304 | GROUP NPI |
| Texas | MEDICAID | 041984803 | GROUP NPI |
| Texas | MEDICAID | 132451722 | GROUP NPI |
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