Mark Fredrickson, MD
Physical Medicine & Rehabilitation in San Antonio, TX. Individual provider (NPI-1).
NPI number1962519959
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1962519959
- Entity type
- Individual (NPI-1)
- Name
- Mark Fredrickson
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 24, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICAL MEDICINE AND REHABILITATION
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | K9535 | TX | Yes |
Practice location
4502 Medical DrSan Antonio, TX 78229-4402
Phone 210-257-1400
Mailing address
Uthscsa, Uthscsa, Dept. Of Rehab Medicine7703 Floyd Curl Drive, Rm 628l
San Antonio, TX 78229
Phone 210-358-4451
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