Provider Demographics
NPI:1033340393
Name:MAGRUDER, MARY A (AUD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:A
Last Name:MAGRUDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:MAGRUDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:11777 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3513
Mailing Address - Country:US
Mailing Address - Phone:281-469-4688
Mailing Address - Fax:281-477-9898
Practice Address - Street 1:11777 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3513
Practice Address - Country:US
Practice Address - Phone:281-469-4688
Practice Address - Fax:281-477-9898
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50704231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist