Provider Demographics
NPI:1275311326
Name:KOLEBER, MARY E
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:KOLEBER
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 1:100 COBBLESTONE ROW
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-7202
Mailing Address - Country:US
Mailing Address - Phone:940-395-0391
Mailing Address - Fax:
Practice Address - Street 1:2214 EMERY ST STE 510
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2476
Practice Address - Country:US
Practice Address - Phone:940-239-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program