Healthcare Provider Details

I. General information

NPI: 1114988094
Provider Name (Legal Business Name): MARY HELEN MORROW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 S MADISON ST
MADISONVILLE TX
77864-1956
US

IV. Provider business mailing address

604 S MADISON ST
MADISONVILLE TX
77864-1956
US

V. Phone/Fax

Practice location:
  • Phone: 936-348-2284
  • Fax: 936-348-2294
Mailing address:
  • Phone: 936-348-2284
  • Fax: 936-348-2294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK3348
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: