Provider Demographics
NPI:1164513297
Name:BORSES, MARY (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:BORSES
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 1:30 GARDEN CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5302
Mailing Address - Country:US
Mailing Address - Phone:831-647-1123
Mailing Address - Fax:831-647-1089
Practice Address - Street 1:30 GARDEN CT
Practice Address - Street 2:SUITE B
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5302
Practice Address - Country:US
Practice Address - Phone:831-647-1123
Practice Address - Fax:831-647-1089
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4717207RC0000X
CAG79195207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200605802Medicaid
TX8CU860OtherBCBS
TX200605804Medicaid
TX200605805Medicaid
TX200605803Medicaid
TXTXB130142Medicare PIN
TX200605803Medicaid
TX8CU860OtherBCBS
TX341185YL9XMedicare PIN