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General NPI Number Information
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NPI Number | 1932320967
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Entity Type | Individual
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Provider Name | MARK KARAKOURTIS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 03/09/2018
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Provider Practice Location Address
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Address Line | 5656 BEE CAVE RD SUITE C102
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5280
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Country | US
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Telephone | 512-327-9933
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Fax | 512-327-9944
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Provider Business Mailing Address
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Address Line | 7517 CAMERON RD SUITE 107
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City | AUSTIN
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State | TX
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Zip | 78752-2057
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Country | US
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Telephone | 512-371-1222
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Fax | 512-371-3914
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 15919
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | L5003
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | L5003
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License Number State | TX
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