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Individual

DR. MARK GLYNN DAVIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6600 FISH POND RD STE 101, WACO, TX 76710-2582
(254) 776-3188
(254) 776-3671
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 358-2074

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
M8620
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01995142
NY
05
1807532
LA
05
196915601
TX
05
196915602
TX
05
196915603
TX
01
8AP706
BLUE CROSS BLUE SHIELD
TX
01
P00633958
RAILROAD MEDICARE
TX
01
P01039325
RR MEDICARE
TX
Enumeration date
06/28/2006
Last updated
09/13/2023
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