Organization
MARY T. WHITAKER, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL A HOOD (PRACTICE ADMINISTRATOR)
(972) 378-3153
Entity
Organization
Contact information
Practice address
3612 SHANTARA LN, PLANO, TX 75093-7621
(972) 378-3153
(972) 378-3154
Mailing address
PO BOX 118405, CARROLLTON, TX 75011-8405
(972) 378-3153
(972) 378-3154
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H0930
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00B37Y
BCBS
TX
Enumeration date
01/15/2008
Last updated
01/15/2008
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