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General NPI Number Information
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NPI Number | 1831476142
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Entity Type | Organization
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Legal Business Name | MARK EDWARD SCROGGINS, M.D. P.A.
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Dates
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Enumeration Date | 11/15/2011
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 2612 HARWOOD RD STE A
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City | BEDFORD
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State | TX
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Zip | 76021-8308
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Country | US
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Telephone | 817-283-8366
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Fax | 817-283-8466
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Provider Business Mailing Address
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Address Line | 2612 HARWOOD RD STE A
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City | BEDFORD
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State | TX
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Zip | 76021-8308
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Country | US
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Telephone | 817-283-8366
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Fax | 817-283-8466
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK E SCROGGINS
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Credential | MD
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Telephone | 817-283-8366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E8892
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License Number State | TX
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