| Doctor Name: | MR. MARK DWAYNE ASMUSSEN |
| NPI Number: | 1134427602 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | PA07059 |
| Business Practice Address: | 118 Shenandoah Dr Suite A Shenandoah, TX - 773811204 |
| Business Phone Number: | 2815834000 |
| Business Fax Number: | 2815805079 |
| Mailing Address: | 118 Shenandoah Dr, Suite A SHENANDOAH |
| State: | TX |
| Postal Code: | 773811204 |
| Phone Number: | 2815834000 |
| Fax Number: | 2815805079 |
| NPI Enumeration Date: | 03/08/2011 |
| NPI Last Update Date: | 09/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA07059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |