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General NPI Number Information
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NPI Number | 1063631794
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Entity Type | Organization
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Legal Business Name | MARY GEDA M D P A
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4534 HIGHWAY 6 N # B
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City | HOUSTON
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State | TX
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Zip | 77084-3402
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Country | US
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Telephone | 281-859-8855
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Fax | 281-345-0732
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Provider Business Mailing Address
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Address Line | 4534 HIGHWAY 6 N # B
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City | HOUSTON
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State | TX
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Zip | 77084-3402
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Country | US
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Telephone | 281-859-8855
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Fax | 281-345-0732
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Authorized Official
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Title or Position | PEDIATRICIAN PRESIDENT
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Name | DR. MARY WILMA GEDA
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Credential | M D
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Telephone | 281-859-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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