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NPI Code Detail

MEDICARE: BART R MAYRON MD

MEDICARE: BART R MAYRON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianJ1306TX

General Provider Information

NPI Number : 1477698108
Entity Type Code : Individual
Provider Name (Legal Business Name) : BART R MAYRON MD
Provider Business Mailing Address
First Line : 2405 MISSOURI AVE
Second Line :
City : MIDLAND
State : TX
Zip : 79701
Country : US
Telephone Number : 432-683-2723
Fax Number : 432-683-4907
Provider Business Practice Location Address
First Line : 2405 W MISSOURI AVE
Second Line :
City : MIDLAND
State : TX
Zip : 79701-6800
Country : US
Telephone Number : 432-683-2723
Fax Number : 432-683-4907
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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Directions to “ BART R MAYRON MD” Practice Location

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