Basic Information
| Provider Information | |||||||||
| NPI: | 1538335310 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MARK D. TOWNS, MD, LOUIS HUNKE MD, THOMAS DEACON MD | ||||||||
| LastName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | PEDIATRICS SOUTHWEST | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2828 DUKE OF GLOUCESTER ST | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | DESOTO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751152067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722983888 | ||||||||
| FaxNumber: | 9722960838 | ||||||||
| Practice Location | |||||||||
| Address1: | 2828 DUKE OF GLOUCESTER ST | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | DESOTO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751152067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722983888 | ||||||||
| FaxNumber: | 9722960838 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2008 | ||||||||
| LastUpdateDate: | 05/01/2008 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | JANIE | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PATIENT ACCOUNTS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9722983888 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.