Physician Compare National (NPI:1932196896)

HEALTHCARE PROVIDER: ROBERT D 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	1932196896
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1951431758
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100604000442
	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	ROBERT
	Individual professional first name
Provider Middle Name	DUANE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1976
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1120 MEDICAL PLAZA DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 380
	Group Practice or individual's line 2 address
City	SHENANDOAH
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	773803243
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2813633311
	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	450184
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HERMANN HOSPITAL SYSTEM
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y