Provider Demographics
NPI:1356326938
Name:HULL, MARY JO KATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY JO
Middle Name:KATHERINE
Last Name:HULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARY JO
Other - Middle Name:KATHERINE
Other - Last Name:ROHRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4330 MEDICAL DR STE 500
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3318
Mailing Address - Country:US
Mailing Address - Phone:210-558-0122
Mailing Address - Fax:210-558-0120
Practice Address - Street 1:4330 MEDICAL DR STE 500
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3318
Practice Address - Country:US
Practice Address - Phone:210-558-0122
Practice Address - Fax:210-558-0120
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI35351207RC0000X
TXM2779207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease