Individual
MARY ANN PISKUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1801 HALSTEAD ST, SUITE B, AMARILLO, TX 79106-1830
(806) 358-8731
(806) 358-8837
Mailing address
500 QUAIL CREEK DR, UNIT B, AMARILLO, TX 79124-1637
(806) 358-8731
(806) 358-8837
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
K0156
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0090EJ
BCBS
TX
05
—
096447001
—
TX
01
—
121567100
FIRSTCARE/SWLH
TX
01
—
240006650
RAILROAD MEDICARE
TX
Enumeration date
08/24/2006
Last updated
07/20/2018
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