Organization
MLMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L LOBAUGH MD (OWNER)
(254) 519-2229
Entity
Organization
Contact information
Practice address
2111 S CLEAR CREEK RD, KILLEEN, TX 76549-4110
(254) 519-2229
(254) 519-2231
Mailing address
PO BOX 938, KILLEEN, TX 76540-0938
(254) 634-6999
(254) 200-4099
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L3544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196049401
—
TX
Enumeration date
06/04/2008
Last updated
12/31/2008
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