Provider Demographics
NPI:1861467904
Name:ROBSON, MARK SCOTT (DPM)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:SCOTT
Last Name:ROBSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4310 JAMES CASEY ST
Mailing Address - Street 2:3A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1120
Mailing Address - Country:US
Mailing Address - Phone:512-441-3668
Mailing Address - Fax:512-448-4460
Practice Address - Street 1:4310 JAMES CASEY ST
Practice Address - Street 2:3A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1120
Practice Address - Country:US
Practice Address - Phone:512-441-3668
Practice Address - Fax:512-448-4460
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDPM1257213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU50905Medicare UPIN
TXN10RMedicare ID - Type Unspecified