Provider Demographics
NPI:1396768347
Name:FLORIAN, MARK JULIUS (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:JULIUS
Last Name:FLORIAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3201 UNIVERSITY DR E
Mailing Address - Street 2:SUITE 345
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3475
Mailing Address - Country:US
Mailing Address - Phone:979-731-8465
Mailing Address - Fax:
Practice Address - Street 1:3201 UNIVERSITY DR E
Practice Address - Street 2:SUITE 345
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3475
Practice Address - Country:US
Practice Address - Phone:979-731-8465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK2017207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742895187OtherTRICARE
TX8AJ762OtherBLUE CROSS BLUE SHIELD
TX0307373-01Medicaid
TX0307373-01Medicaid
TX742895187OtherTRICARE