Provider Demographics
NPI:1922088756
Name:VONO, MARY E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:VONO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 EXECUTIVE CENTER DR STE 250
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1678
Mailing Address - Country:US
Mailing Address - Phone:512-579-4000
Mailing Address - Fax:512-222-0146
Practice Address - Street 1:3445 EXECUTIVE CENTER DR STE 250
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1678
Practice Address - Country:US
Practice Address - Phone:512-579-4000
Practice Address - Fax:512-222-0146
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4788207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158809701Medicaid
TXH71897Medicare UPIN
TX8A0152Medicare ID - Type Unspecified
TX8A4171Medicare ID - Type Unspecified
TX158809701Medicaid