Provider Demographics
NPI:1649152265
Name:CYR, MARY CATHERINE
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:CATHERINE
Last Name:CYR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 OAKRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-1853
Mailing Address - Country:US
Mailing Address - Phone:603-674-5270
Mailing Address - Fax:
Practice Address - Street 1:2621 DRIVE OF CHAMPIONS
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79409
Practice Address - Country:US
Practice Address - Phone:603-674-5270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT91842255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer