MEDICARE: SCOTT WARREN MARKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1659587939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT WARREN MARKS

Provider Business Mailing Address
First Line	:	4757 MAIN AVE
Second Line	:
City	:	GROVES
State	:	TX
Zip	:	77619-4740
Country	:	US
Telephone Number	:	409-963-2331
Fax Number	:	409-963-2346

Provider Business Practice Location Address
First Line	:	4757 MAIN AVE
Second Line	:
City	:	GROVES
State	:	TX
Zip	:	77619-4740
Country	:	US
Telephone Number	:	409-963-2331
Fax Number	:	409-963-2346

Authorized Official
Title or Position	:	OWNER
Name	:	MR. SCOTT WARREN MARKS
Credential	:
Telephone Number	:	409-963-2331

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	08/22/2020

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Directions to “SCOTT WARREN MARKS ” Practice Location

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