Provider Demographics
NPI:1538169644
Name:PICONE, MARK F (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:F
Last Name:PICONE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:7800 SHOAL CREEK BLVD
Mailing Address - Street 2:SUITE 205N
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1098
Mailing Address - Country:US
Mailing Address - Phone:512-206-4341
Mailing Address - Fax:512-407-1947
Practice Address - Street 1:3801 N LAMAR BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4080
Practice Address - Country:US
Practice Address - Phone:512-206-3600
Practice Address - Fax:512-454-2581
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2022-02-10
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Provider Licenses
StateLicense IDTaxonomies
TXL4094207RC0000X
TXI4094207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1507667-01Medicaid
TX1507667-01Medicaid
TX8493K5Medicare PIN
TX8L11494Medicare PIN