Provider Demographics
NPI:1760258800
Name:TRIANA, MARY M
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:TRIANA
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 1:7206 ROCK KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-1723
Mailing Address - Country:US
Mailing Address - Phone:210-906-0833
Mailing Address - Fax:
Practice Address - Street 1:7206 ROCK KNOLL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-1723
Practice Address - Country:US
Practice Address - Phone:210-906-0833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider