Individual
MARK W HUBBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3551 ROGER BROOKE DR RM 448-13, FORT SAM HOUSTON, TX 78234-4504
(210) 916-4029
Mailing address
3551 ROGER BROOKE DR RM 448-13, FORT SAM HOUSTON, TX 78234-4504
(210) 916-4029
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD2011-0113
NM
208D00000X
General Practice Physician
10084
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457372831
TRICARE
—
Enumeration date
07/21/2006
Last updated
08/14/2023
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