Provider Demographics
NPI:1699033373
Name:STEPHENS, MARK THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:THOMAS
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11442 N CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6602
Mailing Address - Country:US
Mailing Address - Phone:214-754-0000
Mailing Address - Fax:303-800-2078
Practice Address - Street 1:2380 S GOLIAD ST STE 100
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6504
Practice Address - Country:US
Practice Address - Phone:214-225-2577
Practice Address - Fax:972-722-4858
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2021-12-02
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Provider Licenses
StateLicense IDTaxonomies
TXQ7114207W00000X
GARTP006172207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology