Provider Demographics
NPI:1639494743
Name:MOK, IVAN ENRIQUE (DO)
Entity Type:Individual
Prefix:
First Name:IVAN
Middle Name:ENRIQUE
Last Name:MOK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4545 POST OAK PLACE DR
Mailing Address - Street 2:130
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3164
Mailing Address - Country:US
Mailing Address - Phone:713-960-8008
Mailing Address - Fax:713-960-0965
Practice Address - Street 1:4545 POST OAK PLACE DR
Practice Address - Street 2:130
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3164
Practice Address - Country:US
Practice Address - Phone:713-960-8008
Practice Address - Fax:713-960-0965
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN2196207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine