Individual
DR. MARK DOUGLAS STATLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1535 E COMMON ST, NEW BRAUNFELS, TX 78130-3154
(830) 625-9153
Mailing address
1535 COMMON ST, NEW BRAUNFELS, TX 78130-3154
(830) 625-9153
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G3815
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121490001
—
TX
Enumeration date
05/18/2006
Last updated
08/03/2011
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