Provider Demographics
NPI:1275575177
Name:NETOSKIE, MARK JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JOHN
Last Name:NETOSKIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4614 SHETLAND LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-6208
Mailing Address - Country:US
Mailing Address - Phone:713-703-3085
Mailing Address - Fax:
Practice Address - Street 1:2700 POST OAK BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5784
Practice Address - Country:US
Practice Address - Phone:713-576-4465
Practice Address - Fax:860-697-7990
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2639208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics