Provider Demographics
NPI:1043372055
Name:HARR, MARY BETH (MD)
Entity type:Individual
Prefix:MRS
First Name:MARY BETH
Middle Name:
Last Name:HARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY BETH
Other - Middle Name:
Other - Last Name:MYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7950 FLOYD CURL DR
Mailing Address - Street 2:SUITE 805
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3919
Mailing Address - Country:US
Mailing Address - Phone:210-614-1112
Mailing Address - Fax:210-614-1113
Practice Address - Street 1:7950 FLOYD CURL DR
Practice Address - Street 2:SUITE 805
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3919
Practice Address - Country:US
Practice Address - Phone:210-614-1112
Practice Address - Fax:210-614-1113
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8107N0Medicare PIN
TXG52262Medicare UPIN