Provider Demographics
NPI:1023223609
Name:STRIEGEL, MARY REGINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:REGINA
Last Name:STRIEGEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4585
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4585
Mailing Address - Country:US
Mailing Address - Phone:956-821-4760
Mailing Address - Fax:956-627-0969
Practice Address - Street 1:801 E NOLANA ST
Practice Address - Street 2:SUITE 17
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6104
Practice Address - Country:US
Practice Address - Phone:956-821-4760
Practice Address - Fax:956-627-0969
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2011-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30757103T00000X, 103TC0700X, 101YM0800X, 103TC2200X, 101Y00000X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0057ESOtherBC BS OF TEXAS
TX096844801Medicaid
TX0057ESOtherBC BS OF TEXAS