Physician Compare National (NPI:1346567757)

HEALTHCARE PROVIDER: MARK ANTHONY DANIELS M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1346567757
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6800167883
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170809003136
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DANIELS
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	TEXAS PLASTIC SURGERY ASSOCIATES, PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3274708797
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	800 12TH AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	FORT WORTH
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	761042519
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8178100770
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450880
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BAYLOR SURGICAL HOSPITAL AT FORT WORTH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450137
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER FORT WORTH
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y