Provider Demographics
NPI:1689763120
Name:ROBBINS, MARK I (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:I
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10281 KETTLER RD
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833
Mailing Address - Country:US
Mailing Address - Phone:512-903-5102
Mailing Address - Fax:724-933-6536
Practice Address - Street 1:10281 KETTLER RD
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833
Practice Address - Country:US
Practice Address - Phone:512-903-5102
Practice Address - Fax:724-933-6536
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA550122085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BR0303040OtherDEA
BR0303040OtherDEA
MA30002099Medicare ID - Type Unspecified