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Organization
MARK E SOWELL DPM INC
Active
Organization
MARK E SOWELL DPM INC
Active
Other names
SOWELL PODIATRY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E SOWELL DPM (OWNER)
(936) 559-1700
Entity
Organization
Contact information
Practice address
3316 N UNIVERSITY DR, SUITE C, NACOGDOCHES, TX 75965-2632
(936) 559-1700
(936) 559-1713
Mailing address
3316 N UNIVERSITY DR, SUITE C, NACOGDOCHES, TX 75965-2632
(936) 559-1700
(936) 559-1713
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
1449
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0096DS
BLUE CROSS/BLUE SHIELD
TX
05
—
018599301
—
TX
01
—
480029919
RAILROAD MEDICARE PTAN
TX
Enumeration date
04/29/2008
Last updated
04/14/2011
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