Provider Demographics
NPI:1700042017
Name:BADIGER, MALLIKARJUN (MD)
Entity Type:Individual
Prefix:
First Name:MALLIKARJUN
Middle Name:
Last Name:BADIGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 S NEW BRAUNFELS AVE
Mailing Address - Street 2:SUTE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3005
Mailing Address - Country:US
Mailing Address - Phone:210-531-8243
Mailing Address - Fax:210-531-8243
Practice Address - Street 1:6711 S NEW BRAUNFELS AVE
Practice Address - Street 2:SUTE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3005
Practice Address - Country:US
Practice Address - Phone:210-531-8243
Practice Address - Fax:210-531-8243
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP18452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry