Provider Demographics
NPI:1760651384
Name:BARAD, MARY BETH (NP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:BETH
Last Name:BARAD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 E SONTERRA
Mailing Address - Street 2:STE. 111, QUIROZ ADULT MEDICINE CLINIC
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:210-404-0127
Mailing Address - Fax:210-404-0161
Practice Address - Street 1:20306 ENCINO LEDGE
Practice Address - Street 2:STE. 103, QUIROZ ADULT MEDICINE CLINIC
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-1831
Practice Address - Country:US
Practice Address - Phone:210-404-0127
Practice Address - Fax:210-404-0161
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP116813363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health