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Individual

MARYSA D. MUMPHREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
4085 DE ZAVALA RD STE 150, SHAVANO PARK, TX 78249-2084
(469) 789-6767
(210) 368-6617
Mailing address
4085 DE ZAVALA RD STE 150, SHAVANO PARK, TX 78249-2084
(210) 368-6614
(210) 368-6617

Taxonomy

Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
S2430
TX
208M00000X
Hospitalist Physician
S2430
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
412831601
TX
01
412831602
CSHCN
TX
Enumeration date
05/19/2015
Last updated
07/21/2025
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