Individual
MARK D BOGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 W BEN WHITE BLVD, AUSTIN, TX 78704-8095
(512) 730-4800
(888) 975-0945
Mailing address
PO BOX 161581, AUSTIN, TX 78716-1581
(512) 363-5779
(512) 292-4458
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
L3246
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150774101
—
TX
Enumeration date
01/27/2006
Last updated
02/01/2018
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