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NPI Code Detail

MEDICARE: DR. MARK EDWARD HERRERA M.D.

MEDICARE: DR. MARK EDWARD HERRERA M.D.
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
12085R0202XDiagnostic Radiology Physician44345WA

General Provider Information

NPI Number : 1629059209
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK EDWARD HERRERA M.D.
Provider Business Mailing Address
First Line : 1820 PRESTON PARK BLVD
Second Line : 1200
City : PLANO
State : TX
Zip : 75093-3656
Country : US
Telephone Number : 972-867-7862
Fax Number : 972-612-1623
Provider Business Practice Location Address
First Line : 3901 W 15TH ST
Second Line :
City : PLANO
State : TX
Zip : 75075-7738
Country : US
Telephone Number : 972-596-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 08/15/2013

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