Physician Compare National (NPI:1598024564)

HEALTHCARE PROVIDER: REBEKAH CONDIT MULLIGAN M.D.

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

Individual Professional Information
NPI	1598024564
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2163662974
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170801001095
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MULLIGAN
	Individual professional last name
Provider First Name	REBEKAH
	Individual professional first name
Provider Middle Name	CONDIT
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	TEXAS HEALTH PHYSICIANS GROUP
	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	4385535954
	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	970
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3801 WILLIAM D TATE AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 850
	Group Practice or individual's line 2 address
City	GRAPEVINE
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	760518757
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8173103070
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450639
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TEXAS HEALTH HARRIS METHODIST HURST-EULESS-BEDFORD
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y