Provider Demographics
NPI:1932102290
Name:HARMON, MARK KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:KEVIN
Last Name:HARMON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3345 PLAZA 10 DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-2553
Mailing Address - Country:US
Mailing Address - Phone:409-833-0444
Mailing Address - Fax:409-833-9039
Practice Address - Street 1:3345 PLAZA 10 DR
Practice Address - Street 2:STE B
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-2553
Practice Address - Country:US
Practice Address - Phone:409-833-0444
Practice Address - Fax:409-833-9039
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2012-10-02
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Provider Licenses
StateLicense IDTaxonomies
TXH7063207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136251904Medicaid
TX136251904Medicaid
TXF09297Medicare UPIN