Provider Demographics
NPI:1902878770
Name:HOOD, MARY KATHRYN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:KATHRYN
Last Name:HOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:280 W RENNER RD APT 2011
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1354
Mailing Address - Country:US
Mailing Address - Phone:972-675-3223
Mailing Address - Fax:972-675-3290
Practice Address - Street 1:3671 BROADWAY BLVD STE 400
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1686
Practice Address - Country:US
Practice Address - Phone:972-840-0001
Practice Address - Fax:972-840-0003
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6472207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00316505OtherMEDICARE RAILROAD PTAN
TX0070DYOtherBCBS
TX1013105204OtherMEDICARE RAILROAD PIN
TX8F1848Medicare PIN
TX1013105204OtherMEDICARE RAILROAD PIN