Provider Demographics
NPI:1528137833
Name:SALDANA, MARK ANDREW (PA-C)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:ANDREW
Last Name:SALDANA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1521 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-5321
Mailing Address - Country:US
Mailing Address - Phone:936-829-4749
Mailing Address - Fax:936-829-5950
Practice Address - Street 1:1111 W FRANK AVE STE 100
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3390
Practice Address - Country:US
Practice Address - Phone:936-639-2244
Practice Address - Fax:936-639-2420
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2019-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA00796363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00408RMedicare ID - Type UnspecifiedGROUP NUMBER
TX85N923Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER