Provider Demographics
NPI:1821086471
Name:MULROY, PATRICK W (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:W
Last Name:MULROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 VILLAGE DR
Mailing Address - Street 2:STE 118
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5509
Mailing Address - Country:US
Mailing Address - Phone:210-222-2606
Mailing Address - Fax:210-222-8410
Practice Address - Street 1:8601 VILLAGE DR
Practice Address - Street 2:STE 118
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5509
Practice Address - Country:US
Practice Address - Phone:210-222-2606
Practice Address - Fax:210-222-8410
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ8327208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K1189OtherBCBS
TX127473005Medicaid
TX8K1189OtherBCBS
TXG03367Medicare UPIN