Provider Demographics
NPI:1891088902
Name:MARK H. TOMPKINS, D.P.M., P.C.
Entity Type:Organization
Organization Name:MARK H. TOMPKINS, D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:210-341-2202
Mailing Address - Street 1:4402 VANCE JACKSON RD
Mailing Address - Street 2:SUITE 146
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5336
Mailing Address - Country:US
Mailing Address - Phone:210-341-2202
Mailing Address - Fax:210-341-0706
Practice Address - Street 1:4402 VANCE JACKSON RD
Practice Address - Street 2:SUITE 146
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5336
Practice Address - Country:US
Practice Address - Phone:210-341-2202
Practice Address - Fax:210-341-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1301213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB131508Medicare PIN
TXTXB131507Medicare PIN