Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | UNKNOWN | TX |
N | 208600000X | Surgeon | UNKNOWN | TX |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | M6832 | TX |
NPI | 1134338114 |
---|---|
Provider Name | John Mark Pool |
First Address | Dallas, TX 75231-4409 |
Second Address | Dallas, TX 75231-4409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 03/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
281326301 | (05) | TX |
281326302 | (05) | TX |
281326303 | (05) | TX |
P00735791 | RAILROAD MEDICARE (01) | TX |