Provider Demographics
NPI:1730584632
Name:WATSON, MARY NELSON (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:NELSON
Last Name:WATSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13679 STEVENS POINT DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-0416
Mailing Address - Country:US
Mailing Address - Phone:214-872-1869
Mailing Address - Fax:214-872-1869
Practice Address - Street 1:13679 STEVENS POINT DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-0416
Practice Address - Country:US
Practice Address - Phone:214-872-1869
Practice Address - Fax:214-872-1869
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6769207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine