Organization
MARK PRETORIUS, M.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PRETORIUS M.D. (PRESIDENT)
(972) 596-5144
Entity
Organization
Contact information
Practice address
5201 CORINTHIAN BAY DR, PLANO, TX 75093-4028
(972) 596-5144
(972) 596-2128
Mailing address
5201 CORINTHIAN BAY DR, PLANO, TX 75093-4028
(972) 596-5144
(972) 596-2128
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
F4392
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0050RP
BCBS
TX
05
—
166099501
—
TX
01
—
DD4519
RAILROAD MEDICARE
TX
Enumeration date
02/06/2007
Last updated
11/05/2015
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