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General NPI Number Information
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NPI Number | 1336769405
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Entity Type | Individual
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Provider Name | STEVEN MARI
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Gender | Male
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Dates
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Enumeration Date | 04/19/2020
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 5230 OLD JACKSONVILLE HWY STE 105
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City | TYLER
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State | TX
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Zip | 75703-3766
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Country | US
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Telephone | 430-562-2343
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Fax | 430-562-9918
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Provider Business Mailing Address
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Address Line | 625 19TH ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1900
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Country | US
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Telephone | 205-934-4011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DO2023-1024
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | V5562
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License Number State | TX
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