Provider Demographics
NPI:1972979250
Name:HORDES, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:HORDES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 WELCH ST APT A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-1278
Mailing Address - Country:US
Mailing Address - Phone:713-416-1781
Mailing Address - Fax:
Practice Address - Street 1:1220 WELCH ST APT A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-1278
Practice Address - Country:US
Practice Address - Phone:713-416-1781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical