Provider Demographics
NPI:1407856230
Name:EGERMAN, MARK J (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:EGERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 200649
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-0649
Mailing Address - Country:US
Mailing Address - Phone:281-580-9030
Mailing Address - Fax:281-580-2725
Practice Address - Street 1:3115 COLLEGE PARK DR
Practice Address - Street 2:UNIT 103C
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4000
Practice Address - Country:US
Practice Address - Phone:936-273-1133
Practice Address - Fax:936-273-1335
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG5017207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88G216Medicare PIN
TXB22468Medicare UPIN
TX86X720Medicare PIN
TX88G216Medicare ID - Type Unspecified