Individual
MARK LEE JAYAWANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 SCENIC DR, GEORGETOWN, TX 78626-7724
(512) 715-4227
Mailing address
1900 SCENIC DR., GEORGETOWN, TX 78626
(512) 715-4227
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
13204
ND
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
M7303
TX
Other
Enumeration date
08/31/2006
Last updated
03/01/2016
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