Provider Demographics
NPI:1790976967
Name:THOLANY, MARYANN (MD)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:THOLANY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1919 SOUTH BRAESWOOD
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:832-824-6633
Mailing Address - Fax:832-825-8901
Practice Address - Street 1:1919 S BRAESWOOD BLVD
Practice Address - Street 2:5TH FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4444
Practice Address - Country:US
Practice Address - Phone:832-824-6633
Practice Address - Fax:832-825-8901
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP7862208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1649205295OtherNPI