Provider Demographics
NPI:1770522294
Name:DROGIN, MARK (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:DROGIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9380207Q00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00076MYOtherBCBS GROUP#
TX8V4340OtherBCBS INDIVIDUAL #
TXB30618Medicare UPIN
TX00W007Medicare ID - Type UnspecifiedMEDICARE GRP#
TX8F2073Medicare ID - Type Unspecified