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General NPI Number Information
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NPI Number | 1891858601
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Entity Type | Organization
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Legal Business Name | MARY M BOOKER
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 3100 SANDPIPER DR
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City | BAYTOWN
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State | TX
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Zip | 77521-1929
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Country | US
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Telephone | 713-240-6311
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Fax | 832-217-3142
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Provider Business Mailing Address
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Address Line | 3100 SANDPIPER DR
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City | BAYTOWN
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State | TX
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Zip | 77521-1929
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Country | US
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Telephone | 713-240-6311
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Fax | 832-217-3142
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MARY MINOR BOOKER
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Credential | LBSW-IPR
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Telephone | 713-240-6311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 26110
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License Number State | TX
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