Provider Demographics
NPI:1063767762
Name:ADAIR, MARK JAMES (PT)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:JAMES
Last Name:ADAIR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2719 N US HIGHWAY 75
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2567
Mailing Address - Country:US
Mailing Address - Phone:903-813-0800
Mailing Address - Fax:903-893-4937
Practice Address - Street 1:2719 N US HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2567
Practice Address - Country:US
Practice Address - Phone:903-813-0800
Practice Address - Fax:903-893-4937
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1069722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist