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General NPI Number Information
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NPI Number | 1538144423
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Entity Type | Individual
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Provider Name | MARK L MAYO MD
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Gender | Male
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 6565 WEST LOOP S SUITE 650
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City | BELLAIRE
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State | TX
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Zip | 77401-3500
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Country | US
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Telephone | 713-797-1010
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Fax | 713-357-7290
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Provider Business Mailing Address
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Address Line | 6565 WEST LOOP S SUITE 650
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City | BELLAIRE
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State | TX
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Zip | 77401-3500
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Country | US
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Telephone | 713-797-1010
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Fax | 713-357-7290
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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 | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number | J0106
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | J0106
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License Number State | TX
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