Provider Demographics
NPI:1760710701
Name:MARK E. QUIRING, MD, PA
Entity Type:Organization
Organization Name:MARK E. QUIRING, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIRING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-577-9384
Mailing Address - Street 1:305 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2327
Mailing Address - Country:US
Mailing Address - Phone:903-577-9384
Mailing Address - Fax:903-577-0954
Practice Address - Street 1:305 W 20TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2327
Practice Address - Country:US
Practice Address - Phone:903-577-9384
Practice Address - Fax:903-577-0954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2263174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0067TJOtherBCBCS
TX092208001Medicaid
TX080175092OtherMEDICARE RAILROAD
TX0067TJOtherBCBCS