Provider Demographics
NPI:1558684381
Name:BLOCK, MARY ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:BLOCK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1750 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3600
Mailing Address - Country:US
Mailing Address - Phone:817-280-9933
Mailing Address - Fax:817-280-9966
Practice Address - Street 1:1750 NORWOOD DR
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3600
Practice Address - Country:US
Practice Address - Phone:817-280-9933
Practice Address - Fax:817-280-9966
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH7906207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine