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Organization
MARK FITZGERALD, MD
Active
Organization
MARK FITZGERALD, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK FITZGERALD MD (OWNER/PROVIDER)
(830) 896-9792
Entity
Organization
Contact information
Practice address
401 JUNCTION HWY, KERRVILLE, TX 78028-4202
(830) 896-9792
(830) 896-9751
Mailing address
123 CIBOLO CREEK DR, BOERNE, TX 78006-3216
(830) 896-9792
(830) 896-9751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K0467
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0067LY
BCBS
TX
Enumeration date
12/17/2007
Last updated
12/17/2007
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