Provider Demographics
NPI:1386671840
Name:HYDE, MARY JOY S (DO)
Entity Type:Individual
Prefix:
First Name:MARY JOY
Middle Name:S
Last Name:HYDE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5920 SARATOGA BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4105
Mailing Address - Country:US
Mailing Address - Phone:361-994-5454
Mailing Address - Fax:361-994-5455
Practice Address - Street 1:5920 SARATOGA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4105
Practice Address - Country:US
Practice Address - Phone:361-994-5454
Practice Address - Fax:361-994-5455
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL9040207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167367505Medicaid
TX8C1777Medicare PIN
I13421Medicare UPIN