MEDICARE: JARED DUANE MARKS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA.A10381.RX	LA
2	363A00000X	Physician Assistant	PA11196	TX

General Provider Information

NPI Number	:	1366453177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED DUANE MARKS PA-C

Provider Business Mailing Address
First Line	:	14140 SOUTHWEST FWY STE 200
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3842
Country	:	US
Telephone Number	:	281-649-7000
Fax Number	:	281-240-0030

Provider Business Practice Location Address
First Line	:	780 W SAM HOUSTON PKWY N STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-3944
Country	:	US
Telephone Number	:	281-649-7500
Fax Number	:	713-468-1255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	10/21/2019

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Directions to “ JARED DUANE MARKS PA-C” Practice Location

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