Individual
MARK MAFFET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16811 SOUTHWEST FWY, SUGAR LAND, TX 77479
(281) 690-4678
Mailing address
16811 SOUTHWEST FWY, SUGAR LAND, TX 77479-4728
(281) 690-4678
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
H7633
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
H7633
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128829208
—
TX
05
—
128829209
—
TX
05
—
128829210
—
TX
05
—
128829211
—
TX
05
—
128829212
—
TX
05
—
128829213
—
TX
01
—
1639259039
BLUE CROSS BLUE SHIELD
TX
01
—
610119701
US DEPT OF LABOR
TX
01
—
610119705 BROOKS
US DEPT OF LABOR
TX
01
—
P00894860
RR MEDICARE
TX
01
—
P00916187
MEDICARE RR
TX
01
—
P01089605
RR MEDICARE
TX
05
—
PENDING
—
TX
Enumeration date
10/17/2006
Last updated
06/10/2019
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