Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 596032 | TX |
NPI | 1003148735 |
---|---|
Provider Name | Ms. Mary Rebecca Monaghan |
First Address | The Woodlands, TX 77386-1343 |
Second Address | The Woodlands, TX 77386-1343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2010 |
Last Update Date | 11/10/2012 |