Individual
DR. MARK J PHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2120 ANTILLEY RD, ABILENE, TX 79606-5211
(325) 695-2020
(325) 695-2326
Mailing address
2120 ANTILLEY RD, ABILENE, TX 79606-5211
(325) 695-2020
(325) 695-2326
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
F79809
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039788701
—
TX
01
—
180019658
RRMC
TX
01
—
751531889
TAX ID
—
01
—
81W900
BCBS
TX
Enumeration date
09/22/2005
Last updated
07/10/2025
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