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Individual

DR. MARK EDWARD HENNESSY

Active
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Individual

DR. MARK EDWARD HENNESSY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
N4468
TX
207R00000X
Internal Medicine Physician
9500093
NC
207R00000X
Internal Medicine Physician
Primary
N4468
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11323149
UHC
TX
01
41696
BCBS PROVIDER NUMBER
NC
05
8941696
NC
01
8CQ712
BCBS
TX
Enumeration date
03/22/2006
Last updated
04/29/2024
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