Individual
MRS. MARY M WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
12121 RICHMOND AVE, SUITE#409, HOUSTON, TX 77082-2432
(281) 493-4922
(281) 493-9728
Mailing address
12121 RICHMOND AVE, SUITE#409, HOUSTON, TX 77082-2432
(281) 493-4922
(281) 493-9728
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
456399
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1663882
—
TX
Enumeration date
10/24/2006
Last updated
07/08/2007
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