Pastor, Mary Grace
Pastor, Mary Grace is an individual health care provider with primary practice located at 4450 Highland Ave , Beaumont TX 77705. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pastor, Mary Grace can be contacted via phone (409) 832-1924.Contact Information
Primary practice address
4450 Highland Ave
Beaumont TX 77705
Phone: (409) 832-1924
Fax: (713) 523-4897
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | K6214 | Texas |
Profile Details
| NPI number | 1518966647 |
|---|---|
| LBN Legal business name | Pastor, Mary Grace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2005 |
| Last updated | Jan 18th, 2013 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518966647 | NPPES |
| Texas | MEDICAID | 126826002 | |
| Texas | MEDICAID | 080462703 |
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