Provider Demographics
NPI:1750583910
Name:PRASARN, MARK L (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:L
Last Name:PRASARN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6414 FANNIN ST STE G150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1514
Mailing Address - Country:US
Mailing Address - Phone:713-486-7500
Mailing Address - Fax:713-512-2234
Practice Address - Street 1:6414 FANNIN ST STE G150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1514
Practice Address - Country:US
Practice Address - Phone:713-486-7500
Practice Address - Fax:713-512-2234
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2012-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY248584207X00000X
TXP1389207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX283706401Medicaid
TXZ99428Medicare UPIN
TX283706401Medicaid