Individual
MARY KAY KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6410 FANNIN ST, 1010, HOUSTON, TX 77030-3000
(832) 325-7111
(713) 512-2248
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
FTL 41819
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8W7646
BCBS
TX
Enumeration date
05/29/2007
Last updated
03/27/2008
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