Provider Demographics
NPI:1053533026
Name:EVERS, MARY A (DO)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:A
Last Name:EVERS
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1900 SCENIC DR STE 2208
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7703
Mailing Address - Country:US
Mailing Address - Phone:512-868-9800
Mailing Address - Fax:512-868-9811
Practice Address - Street 1:1900 SCENIC DR STE 2208
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7703
Practice Address - Country:US
Practice Address - Phone:512-868-9800
Practice Address - Fax:512-868-9811
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM6125207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192526501Medicaid
TX192526501Medicaid