Individual
RICHARD H MAUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
950 W MAGNOLIA AVE, FORT WORTH, TX 76104-4501
(817) 336-5060
(817) 336-1744
Mailing address
4637 MARBELLA CIR, FORT WORTH, TX 76126-1927
(817) 733-6566
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
E2284
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10028773
AMERIGROUP
—
01
—
110081715
MEDICARE RAILROAD
—
05
—
118141401
—
TX
01
—
1634476
UNISYS LOUISIANA MEDICAID
—
01
—
4036862
AETNA
—
01
—
834766
BLUE CROSS BLUE SHIELD TX
—
Enumeration date
06/20/2006
Last updated
02/16/2016
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