| Organization Name: | MARYS CLINIC INC |
| NPI Number: | 1871875294 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY ESTHER WELLS (OWNER AND PROVIDER) |
| Mailing Address: | 191 S Manse Ave Giddings |
| State: | TX US |
| Postal Code: | 789423433 |
| Phone Number: | 9795402122 |
| Fax Number: | 9795402120 |
| NPI Enumeration Date: | 09/12/2011 |
| NPI Last Update Date: | 09/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | 257158 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |