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Organization

MARY KELLY GREEN MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY K. GREEN MD (OWNER)
(830) 693-5868
Entity
Organization

Contact information

Practice address
204 GATEWAY N, SUITE A, MARBLE FALLS, TX 78654-6361
(830) 698-5868
(830) 798-8017
Mailing address
204 GATEWAY N, SUITE A, MARBLE FALLS, TX 78654-6361
(830) 698-5868
(830) 798-8017

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
TX
207W00000X
Ophthalmology Physician
Primary
TX

Other

Enumeration date
02/23/2012
Last updated
02/24/2012
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