Individual
MS. MARY S MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4107 MEDICAL PKWY STE 210, AUSTIN, TX 78756-3738
(512) 451-4488
(512) 453-2707
Mailing address
4107 MEDICAL PKWY, #210, AUSTIN, TX 78756-3735
(512) 451-4488
(512) 453-2707
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
H0613
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131432004
—
TX
Enumeration date
09/29/2005
Last updated
01/22/2016
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