Healthcare Provider Details

I. General information

NPI: 1558225870
Provider Name (Legal Business Name): MARIA EUGENIA DYURICH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAYA DYURICH

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 PALMER CIR STE 100
NORMAN OK
73069-6351
US

IV. Provider business mailing address

4003 FAWNRIDGE DR
SAN ANTONIO TX
78229-4209
US

V. Phone/Fax

Practice location:
  • Phone: 210-874-2074
  • Fax:
Mailing address:
  • Phone: 906-767-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: