Individual
MARY F. RED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
8224 PARK LN STE 130, VICKERY HEALTH CENTER, DALLAS, TX 75231-6021
(214) 266-0266
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
607808
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139460315
—
TX
05
—
139460316
—
TX
05
—
139460317
—
TX
05
—
139460318
—
TX
05
—
139460319
—
TX
05
—
139460320
—
TX
05
—
139460321
—
TX
05
—
139460322
—
TX
05
—
139460323
—
TX
05
—
139460324
—
TX
05
—
139460325
—
TX
Enumeration date
12/28/2006
Last updated
06/16/2009
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