Healthcare Provider Details

I. General information

NPI: 1356643175
Provider Name (Legal Business Name): MARK AARON EILERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2010
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20639 KUYKENDAHL RD STE 200
SPRING TX
77379
US

IV. Provider business mailing address

20639 KUYKENDAHL RD STE 200
SPRING TX
77379-3318
US

V. Phone/Fax

Practice location:
  • Phone: 832-698-0111
  • Fax:
Mailing address:
  • Phone: 832-698-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberQ7681
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: