Provider Demographics
NPI:1568250652
Name:KERRIGAN HAUPT, MARIA R (MS/MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:R
Last Name:KERRIGAN HAUPT
Suffix:
Gender:F
Credentials:MS/MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:R
Other - Last Name:KERRIGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS/MD
Mailing Address - Street 1:2900 E 29TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2900 E 29TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2623
Practice Address - Country:US
Practice Address - Phone:979-436-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty