Provider Demographics
NPI:1376551341
Name:COPAS, MARK HIRAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:HIRAM
Last Name:COPAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14025 1/2 FM 2920 RD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-5501
Mailing Address - Country:US
Mailing Address - Phone:281-351-9584
Mailing Address - Fax:
Practice Address - Street 1:14025 1/2 FM 2920 RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-5501
Practice Address - Country:US
Practice Address - Phone:281-351-9584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15302122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist