Provider Demographics
NPI:1861263931
Name:STRAHAN, MARY ANGELA
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANGELA
Last Name:STRAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20994 SHAKEY HOLW
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77306-9426
Mailing Address - Country:US
Mailing Address - Phone:936-270-9961
Mailing Address - Fax:
Practice Address - Street 1:20988 SHAKEY HOLW
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77306-9426
Practice Address - Country:US
Practice Address - Phone:936-270-9961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide