MEDICARE: DR. MARY A. WASHINGTON MD, FACP

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
1	207RN0300X	Nephrology Physician	J0721	TX

General Provider Information

NPI Number	:	1811992894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY A. WASHINGTON MD, FACP

Provider Business Mailing Address
First Line	:	1140 WESTMONT DR
Second Line	:	SUITE 320
City	:	HOUSTON
State	:	TX
Zip	:	77015-4363
Country	:	US
Telephone Number	:	713-637-6320
Fax Number	:	713-637-0735

Provider Business Practice Location Address
First Line	:	1140 WESTMONT DR
Second Line	:	SUITE 320
City	:	HOUSTON
State	:	TX
Zip	:	77015-4363
Country	:	US
Telephone Number	:	713-637-6320
Fax Number	:	713-637-0735

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/10/2011

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