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NPI Code Detail

MEDICARE: MARY ANN PISKUN M.D.

MEDICARE: MARY ANN PISKUN M.D.
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
1208200000XPlastic Surgery PhysicianK0156TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3240006650OTHERTXRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10090EJOTHERTXBCBS
2121567100OTHERTXFIRSTCARE/SWLH
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679680839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ANN PISKUN M.D.
Provider Business Mailing Address
First Line : 500 QUAIL CREEK DR
Second Line : UNIT B
City : AMARILLO
State : TX
Zip : 79124-1637
Country : US
Telephone Number : 806-358-8731
Fax Number : 806-358-8837
Provider Business Practice Location Address
First Line : 1801 HALSTEAD ST
Second Line : SUITE B
City : AMARILLO
State : TX
Zip : 79106-1830
Country : US
Telephone Number : 806-358-8731
Fax Number : 806-358-8837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 07/20/2018

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Directions to “ MARY ANN PISKUN M.D.” Practice Location

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