Individual
TOUG MARK TANAVIN
Active
Individual
TOUG MARK TANAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10049487
TX
207RI0011X
Interventional Cardiology Physician
Primary
63496
TN
Other
Enumeration date
04/09/2014
Last updated
07/19/2021
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