Fragile, Mary Lou

Fragile, Mary Lou is an individual health care provider with primary practice located at 2806 N Navarro St Suite B, Victoria TX 77901-3905. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Fragile, Mary Lou can be contacted via phone (361) 576-4100.

Contact Information

Primary practice address
2806 N Navarro St Suite B Victoria TX 77901-3905
Phone: (361) 576-4100
Fax: (361) 576-4103
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1839 West Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X N3031 Texas

Profile Details

NPI number 1699831586
LBN Legal business name Fragile, Mary Lou
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Jun 25th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699831586 NPPES
Texas Other 0062XG BLUE CROSS
Texas MEDICAID 202614801 BLUE CROSS
Texas Other 8BH061 BLUE CROSS

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