Provider Demographics
NPI:1538144423
Name:MAYO, MARK L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:L
Last Name:MAYO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6565 WEST LOOP S
Mailing Address - Street 2:SUITE 650
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3500
Mailing Address - Country:US
Mailing Address - Phone:713-797-1010
Mailing Address - Fax:713-357-7290
Practice Address - Street 1:6565 WEST LOOP S
Practice Address - Street 2:SUITE 650
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3500
Practice Address - Country:US
Practice Address - Phone:713-797-1010
Practice Address - Fax:713-357-7290
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2019-01-30
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Provider Licenses
StateLicense IDTaxonomies
TXJ0106207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125408801Medicaid
TX8S9544OtherBCBSTX
TX180019404OtherRR MEDICARE
4482580OtherAETNA
TX8S9544OtherBCBSTX
TX125408801Medicaid