Russell, Mary Elizabeth

Russell, Mary Elizabeth is an individual health care provider with primary practice located at 9250 Pinecroft Drive Tirr, Shenandoah TX 77380-3256. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Russell, Mary Elizabeth can be contacted via phone (713) 897-4909.

Contact Information

Primary practice address
9250 Pinecroft Drive Tirr Shenandoah TX 77380-3256
Phone: (713) 897-4909
Fax: (713) 897-4919
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X Q0354 Texas
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X DO-04572 Iowa

Profile Details

NPI number 1194019158
LBN Legal business name Russell, Mary Elizabeth
Credentials D.O., M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2011
Last updated Dec 21st, 2023 - about 2 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 1194019158 NPPES
Texas Other 8HS092 BCBS
Texas MEDICAID 378844001 BCBS
Texas Other 623197YKY3 BCBS

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