Organization
R MARK HAZEL PA
Active
Organization
R MARK HAZEL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R MARK HAZEL MD (OWNER)
(972) 463-4313
Entity
Organization
Contact information
Practice address
6701 HERITAGE PKWY STE 170, ROCKWALL, TX 75087-8798
(972) 463-4313
(972) 463-4245
Mailing address
6701 HERITAGE PKWY STE 170, ROCKWALL, TX 75087-8798
(972) 463-4313
(972) 463-4245
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0025NA
BCBS
TX
Enumeration date
03/31/2008
Last updated
05/21/2008
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