Provider Demographics
NPI:1194042689
Name:MRAZEK, AMY ANN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ANN
Last Name:MRAZEK
Suffix:
Gender:F
Credentials:MD, 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 650859 DEPT 710
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-6944
Mailing Address - Country:US
Mailing Address - Phone:409-772-0620
Mailing Address - Fax:
Practice Address - Street 1:301 UNIVERSITY BLVD.
Practice Address - Street 2:6.146 JOHN SEALY ANNEX
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0527
Practice Address - Country:US
Practice Address - Phone:409-772-1285
Practice Address - Fax:409-772-5611
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS54402086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery