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General NPI Number Information
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NPI Number | 1558531558
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Entity Type | Organization
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Legal Business Name | ROGER G MOBLAD DPM
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 224 WESLEY DR
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City | KERRVILLE
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State | TX
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Zip | 78028-5809
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Country | US
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Telephone | 830-257-7677
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Fax | 830-257-7666
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Provider Business Mailing Address
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Address Line | 224 WESLEY DR
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City | KERRVILLE
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State | TX
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Zip | 78028-5809
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Country | US
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Telephone | 830-257-7677
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Fax | 830-257-7666
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROGER G MOBLAD
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Credential | DPM
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Telephone | 830-257-7677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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