Provider Demographics
NPI:1962203133
Name:QUIBAL, MARY MARGARETTE MISLANG
Entity type:Individual
Prefix:
First Name:MARY MARGARETTE
Middle Name:MISLANG
Last Name:QUIBAL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7215 BOSQUE BLVD STE 167
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-4020
Mailing Address - Country:US
Mailing Address - Phone:254-673-0075
Mailing Address - Fax:254-673-0087
Practice Address - Street 1:7215 BOSQUE BLVD STE 167
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-4020
Practice Address - Country:US
Practice Address - Phone:254-673-0075
Practice Address - Fax:254-673-0087
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)