Individual
DR. MARK W. IZZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY. D.
Contact information
Practice address
1208 WOLFLIN AVE, AMARILLO, TX 79109-2252
(806) 468-7980
(806) 468-7987
Mailing address
1208 WOLFLIN AVE, AMARILLO, TX 79109-2252
(806) 468-7980
(806) 468-7987
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
30789
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012GD
BCBS
TX
Enumeration date
08/03/2006
Last updated
07/08/2007
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