Physician Compare National (NPI:1013963172)

HEALTHCARE PROVIDER: PRESLEY M. MOCK MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1013963172
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8729047386
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100512000147
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOCK
	Individual professional last name
Provider First Name	PRESLEY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	OTOLARYNGOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	TEXAS MEDICAL AND SURGICAL ASSOCIATES PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8123002888
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8440 WALNUT HILL LN
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	DALLAS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	752313833
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450462
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y