Wilde, Mark C.

Wilde, Mark C. is an individual health care provider with primary practice located at 13300 Hargrave Rd Suite 505, Houston TX 77070-4373. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Clinical Neurophysiology is his primary health care specialty. Wilde, Mark C. can be contacted via phone (281) 737-1167.

Contact Information

Primary practice address
13300 Hargrave Rd Suite 505 Houston TX 77070-4373
Phone: (281) 737-1167
Fax: (281) 469-1460
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 25025 Texas
Allopathic & Osteopathic Physicians / Clinical Neurophysiology 2084N0600X 25025 Texas

Profile Details

NPI number 1730148925
LBN Legal business name Wilde, Mark C.
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Feb 27th, 2017 - about 8 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 1730148925 NPPES
Texas MEDICAID 102648606
Texas Other 89680A

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