Provider Demographics
NPI:1114988094
Name:MORROW, MARY HELEN (MD)
Entity Type:Individual
Prefix:
First Name:MARY HELEN
Middle Name:
Last Name:MORROW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77864-1956
Mailing Address - Country:US
Mailing Address - Phone:936-348-2284
Mailing Address - Fax:936-348-2294
Practice Address - Street 1:604 S MADISON ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TX
Practice Address - Zip Code:77864-1956
Practice Address - Country:US
Practice Address - Phone:936-348-2284
Practice Address - Fax:936-348-2294
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1297277-14Medicaid
TX1297277-15OtherCSHCN
TX8K9434OtherBC/BS
TX129727711Medicaid
TXP00220296OtherRR/MEDICARE
TX8P0381OtherBLUE SHIELD
TX8P0381OtherBLUE SHIELD
TX129727711Medicaid
TX8K9434OtherBC/BS