Provider Demographics
NPI:1033794524
Name:BYERS, MARIE THERESA
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:THERESA
Last Name:BYERS
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 1:9503 JONES RD
Mailing Address - Street 2:
Mailing Address - City:JERSEY VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4814
Mailing Address - Country:US
Mailing Address - Phone:281-894-5237
Mailing Address - Fax:281-894-5287
Practice Address - Street 1:9503 JONES RD
Practice Address - Street 2:
Practice Address - City:JERSEY VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:77065-4814
Practice Address - Country:US
Practice Address - Phone:281-894-5237
Practice Address - Fax:281-594-5287
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200081183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician