Individual
MARY KATHERINE WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 BOURLAND RD STE 130, KELLER, TX 76248-3595
(817) 359-9000
(817) 284-8943
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q9763
TX
207RH0003X
Hematology & Oncology Physician
Primary
Q9763
TX
207RX0202X
Medical Oncology Physician
Q9763
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402024001
—
TX
Enumeration date
06/04/2013
Last updated
10/20/2022
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