| Doctor Name: | DR. ROGER M MOCZYGEMBA |
| NPI Number: | 1750382503 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | J2212 |
| Business Practice Address: | 303 Quincy Suite 102 San Antonio, TX - 782151918 |
| Business Phone Number: | 2107400005 |
| Business Fax Number: | 2105192920 |
| Mailing Address: | 1544 Sawdust Rd, Suite 180 SPRING |
| State: | TX |
| Postal Code: | 773802929 |
| Phone Number: | 2812927411 |
| Fax Number: | 2812927481 |
| NPI Enumeration Date: | 08/02/2005 |
| NPI Last Update Date: | 07/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | J2212 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |