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NPI Code Detail

MEDICARE: MARY KATHARINE LYTWYN MD

MEDICARE: MARY KATHARINE LYTWYN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program173193NC
2207P00000XEmergency Medicine PhysicianP9132TX

General Provider Information

NPI Number : 1336433440
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY KATHARINE LYTWYN MD
Provider Business Mailing Address
First Line : 7 TANNERY HILL RD
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77375-4980
Country : US
Telephone Number : 956-472-1238
Fax Number :
Provider Business Practice Location Address
First Line : 20171 CHASEWOOD PARK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77070-1437
Country : US
Telephone Number : 832-534-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2011
Last Update Date : 03/17/2018

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Directions to “ MARY KATHARINE LYTWYN MD” Practice Location

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