Individual
DR. MARK L ELDORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
824 SOUTHPARK CIRCLE, ATHENS, TX 75752
(903) 675-7376
(903) 677-4234
Mailing address
824 SOUTHPARK CIRCLE, ATHENS, TX 75752
(903) 675-7376
(903) 677-4234
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
K0461
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048064207
—
TX
05
—
178423301
—
TX
01
—
8S2730
BCBS PROVIDER NUMBER
TX
Enumeration date
08/10/2005
Last updated
02/07/2012
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