Individual
COREY J. MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1310 PALUXY RD STE 3000, GRANBURY, TX 76048-5655
(817) 579-3906
(817) 579-3905
Mailing address
1310 PALUXY RD STE 3000, GRANBURY, TX 76048-5655
(817) 579-3906
(817) 579-3905
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
752743893
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185888801
—
TX
01
—
8X8661
BCBS
TX
Enumeration date
03/20/2007
Last updated
09/13/2020
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