Provider Demographics
NPI:1215303235
Name:REES, MARY LANETTE (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LANETTE
Last Name:REES
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 1:3510 TURTLE CREEK BLVD
Mailing Address - Street 2:10C
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5544
Mailing Address - Country:US
Mailing Address - Phone:214-718-4080
Mailing Address - Fax:
Practice Address - Street 1:3510 TURTLE CREEK BLVD
Practice Address - Street 2:10C
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5544
Practice Address - Country:US
Practice Address - Phone:214-718-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9590207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology