Provider Demographics
NPI:1902998347
Name:COLLIGAN, MARK F (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:F
Last Name:COLLIGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:502 MADISON OAK
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4084
Mailing Address - Country:US
Mailing Address - Phone:210-483-8883
Mailing Address - Fax:210-494-1740
Practice Address - Street 1:502 MADISON OAK
Practice Address - Street 2:SUITE 310
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4084
Practice Address - Country:US
Practice Address - Phone:210-483-8883
Practice Address - Fax:210-494-1740
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN1291207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
30252AMedicare ID - Type Unspecified
I45491Medicare UPIN