Provider Demographics
NPI:1740365527
Name:SKEELS, MARY FRANCES (CNS/PMH)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:FRANCES
Last Name:SKEELS
Suffix:
Gender:F
Credentials:CNS/PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 SKIPPING STONE LN
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0815
Mailing Address - Country:US
Mailing Address - Phone:903-258-3552
Mailing Address - Fax:
Practice Address - Street 1:409 W FERGUSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-5632
Practice Address - Country:US
Practice Address - Phone:903-596-8353
Practice Address - Fax:903-596-9471
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220957364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N8797OtherBLUE CROSS BLUE SHIELD
TXP00318791OtherRAIL ROAD
TX173339602Medicaid
TX8D7683Medicare ID - Type Unspecified