MARK EDWARD ATHANS LSA NPI 1093833576

NPI Information

NPI: 1093833576
Provider Name: MARK EDWARD ATHANS, LSA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
11822 FM 2432 RD
WILLIS, TX
ZIP 77378
Phone: (832) 581-6369
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Mark Edward Athans, LSA is a surgical physician assistant in Willis, TX. Mark Edward Athans, LSA NPI is 1093833576. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11822 FM 2432 RD
WILLIS, TX
ZIP 77378-912
Phone: (832) 581-6369

The enumeration date for this NPI number is 3/26/2007 and was last updated on 10/27/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246ZS0410X	Specialist/Technologist, Other	Surgical Technologist	SA00029	TEXAS	No
2	363AS0400X	Physician Assistant	Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0004JR	OTHER	TEXAS	BCBS PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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