Individual
MARY KATHERINE HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
305 W RUSK ST, TYLER, TX 75701-1514
(903) 592-7304
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N4462
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214549201
—
TX
05
—
214549202
—
TX
01
—
752616977004
TRICARE
TX
01
—
8BE142
BCBS
TX
Enumeration date
05/25/2010
Last updated
10/13/2014
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