Provider Demographics
NPI:1396050795
Name:MORRIS, MARY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18140 SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1421
Mailing Address - Country:US
Mailing Address - Phone:210-490-5593
Mailing Address - Fax:210-490-8207
Practice Address - Street 1:18140 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1421
Practice Address - Country:US
Practice Address - Phone:210-490-5593
Practice Address - Fax:210-490-8207
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist