Izzard, Mark W.
Izzard, Mark W. is an sole proprietor health care provider with primary practice located at 1208 Wolflin Ave , Amarillo TX 79109-2252. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Izzard, Mark W. can be contacted via phone (806) 468-7980.Contact Information
Primary practice address
1208 Wolflin Ave
Amarillo TX 79109-2252
Phone: (806) 468-7980
Fax: (806) 468-7987
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 30789 | Texas |
Profile Details
| NPI number | 1376550947 |
|---|---|
| LBN Legal business name | Izzard, Mark W. |
| Credentials | PSY. D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1376550947 | NPPES |
| Texas | Other | 0012GD | BCBS |
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