Provider Demographics
NPI:1134187586
Name:STONE, MARK ELDON (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ELDON
Last Name:STONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 E SINTON ST
Mailing Address - Street 2:
Mailing Address - City:SINTON
Mailing Address - State:TX
Mailing Address - Zip Code:78387-2653
Mailing Address - Country:US
Mailing Address - Phone:361-364-5050
Mailing Address - Fax:361-364-5051
Practice Address - Street 1:121 E SINTON ST
Practice Address - Street 2:
Practice Address - City:SINTON
Practice Address - State:TX
Practice Address - Zip Code:78387-2653
Practice Address - Country:US
Practice Address - Phone:361-364-5050
Practice Address - Fax:361-364-5051
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3780111N00000X
TX7342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608396OtherBCBSTX
TX190352801Medicaid
TX608396OtherBCBSTX