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General NPI Number Information
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NPI Number | 1205973526
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Entity Type | Individual
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Provider Name | MARY C NIU MD
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 6621 FANNIN ST WT19, MC19345
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City | HOUSTON
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State | TX
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Zip | 77030-2303
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Country | US
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Telephone | 410-908-2861
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 BISSONNET ST APT 3307
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City | HOUSTON
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State | TX
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Zip | 77005-4092
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Country | US
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Telephone | 410-908-2861
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | P19132
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 10549383-1205
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License Number State | UT
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