Most Relevant Information
Provider Data
| NPI Number: | 1003834599 |
| Provider Name: | MARK BROOKS PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA03324 |
Most Important Dates
| Enumeration Date: | 07/17/2006 |
| Last Updated: | 12/28/2011 |
Provider Practice Location
2401 S 31ST ST
TEMPLE
TX
765080001
Practice Location Phone/Fax
| Phone: | 2547242111 |
| Fax: |
Provider Mailing Location
PO BOX 847556
DALLAS
TX
752847556
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |