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Individual

MARY J GARNEPUDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
403 OGLETREE DR, SUITE 200, LIVINGSTON, TX 77351-9444
(936) 327-7799
Mailing address
403 OGLETREE DR, SUITE 200, LIVINGSTON, TX 77351-9444
(936) 327-7799

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
H8650
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10050921
AMERIGROUP
TX
05
111454804
TX
05
111454806
TX
01
1116871
AETNA
TX
01
21140705603
BEECH STREET
TX
01
48587742
CIGNA
TX
01
8H8816
BCBS
TX
Enumeration date
10/17/2005
Last updated
11/02/2013
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