Mark Fitzgerald, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K0467 Issued in TX

Legal business name

MARK FITZGERALD, MD

Practice address

401 Junction Hwy
Kerrville, TX 78028-4202

Phone

(830) 896-9792

Fax

(830) 896-9751

NPI assigned

Dec 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Fitzgerald, MD

Title

Owner/Provider

Phone

(830) 896-9792

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1497939136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 CIBOLO CREEK DR",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063216",
            "telephone_number": "830-896-9792",
            "fax_number": "830-896-9751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 JUNCTION HWY",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780284202",
            "telephone_number": "830-896-9792",
            "fax_number": "830-896-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK FITZGERALD, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "830-896-9792",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K0467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0067LY",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.