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NPI Code Detail

MEDICARE: HOUSTON MKR, LLC

MEDICARE: HOUSTON MKR, LLC
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
1207Q00000XFamily Medicine PhysicianD5478TX

General Provider Information

NPI Number : 1548349970
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOUSTON MKR, LLC
Provider Business Mailing Address
First Line : 5962 RENWICK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77081-2406
Country : US
Telephone Number : 713-777-9887
Fax Number : 713-777-9926
Provider Business Practice Location Address
First Line : 5962 RENWICK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77081-2406
Country : US
Telephone Number : 713-777-9887
Fax Number : 713-777-9926
Authorized Official
Title or Position : ADMINISTRATOR
Name : MARK ALAN LEVENSON
Credential :
Telephone Number : 713-679-0003
Provider Enumeration Date : 11/05/2006
Last Update Date : 01/15/2010

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Directions to “HOUSTON MKR, LLC ” Practice Location

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