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Individual

MARK T OGDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
111 DALLAS ST, EMERGENCY ROOM, SAN ANTONIO, TX 78205-1201
(210) 614-0180
(210) 615-7170
Mailing address
PO BOX 12740, WESTMINSTER, CA 92685-2740
(562) 468-0227
(562) 467-0865

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M4406
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
M4406
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
183200801
TX
05
183200802
TX
05
183200805
TX
01
8AB501
BCBS
TX
01
8W4062
BCBS
TX
Enumeration date
07/11/2006
Last updated
12/07/2009
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