Provider Demographics
NPI:1811194665
Name:MARK DROGIN, M.D. P.A.
Entity Type:Organization
Organization Name:MARK DROGIN, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DROGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:210-491-4300
Mailing Address - Street 1:PO BOX 957
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78294-0957
Mailing Address - Country:US
Mailing Address - Phone:210-491-4300
Mailing Address - Fax:210-495-1029
Practice Address - Street 1:23445 US HIGHWAY 281 N
Practice Address - Street 2:BUILDING #2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7317
Practice Address - Country:US
Practice Address - Phone:210-491-4300
Practice Address - Fax:210-495-1029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9380207Q00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00076MYOtherBCBS GROUP #
TX8V4340OtherBCBS INDIVIDUAL #
TX00076MYOtherBCBS GROUP #
TX00W007Medicare ID - Type UnspecifiedMEDICARE GROUP #
TX8V4340OtherBCBS INDIVIDUAL #