Provider Demographics
NPI:1790723013
Name:HOUSTON, MARK C (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:C
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-297-2700
Practice Address - Fax:615-269-4584
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2015-05-12
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Provider Licenses
StateLicense IDTaxonomies
TN10516207R00000X, 207RH0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1507589Medicaid
TN10075140OtherAMERIGROUP
TN0440440OtherUNITED HEALTH CARE
TN4067698OtherAETNA
TN110219098OtherMEDICARE RR
TN3164320OtherBLUE CROSS OF TN
KY64746076Medicaid
TN633837OtherUSO MCO
TN2576056OtherCIGNA
TN10075140OtherAMERIGROUP
B03128Medicare UPIN
TN4067698OtherAETNA