Individual
MARY R PRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 PALM ST, AMARILLO, TX 79107-2056
(806) 731-0593
Mailing address
2800 PALM ST, AMARILLO, TX 79107-2056
(806) 731-0593
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/16/2011
Last updated
06/16/2011
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