DR. MARY MADISON EAGLE (NPI# 1639625171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639625171 |
| Entity Type | Individual |
| Full Name | DR. MARY MADISON EAGLE |
| Credential | PH.D. |
| Practice Address |
4837 Bryce Ave Fort Worth TX 76107-4144 |
| Practice Telephone | 8179807474 |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
16-18P | AR | Behavioral Health & Social Service Providers |
| Street Address |
4837 BRYCE AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-4144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265931349 | Ramona Diane Burroughs | Psychologist | 855 Montgomery St Fl 4, Fort Worth, TX 76107-2553 | 2018-02-05 |
| 1689115438 | Hayley Blackwood | Psychologist | 15833 Bent Rose Way, Fort Worth, TX 76177 | 2017-03-13 |
| 1326582941 | David K. Carlson | Psychologist | 5112 Leeray Rd, Fort Worth, TX 76244-9233 | 2016-12-16 |
| 1831546944 | Kalima Charway | Psychologist | 4532 Endercrest Lane, Fort Worth, TX 76123 | 2016-05-18 |
| 1821332628 | Patricia Byrd | Psychologist | 3000 'j' Street, Fort Worth, TX 76127 | 2012-11-16 |
| 1629224068 | Daniel Rayner Altman | Psychologist | 1200 W Magnolia Ave, Suite 210, Fort Worth, TX 76104-4481 | 2008-08-18 |
| 1407027279 | Mary Cecilia Robertson | Psychologist | 6420 Southwest Blvd, Suite 112, Fort Worth, TX 76109 | 2008-03-19 |
| 1043429426 | Nichelle E. Wiggins | Psychologist | 3804 E Lancaster Ave, Fort Worth, TX 76103-3523 | 2007-05-22 |
| 1871718007 | George C. Denkowski | Psychologist | 1701 River Run Ste 1105, Fort Worth, TX 76107-6557 | 2007-04-14 |
| 1104945757 | John Savell | Psychologist | 1200 Clara St, Fort Worth, TX 76110-1008 | 2007-03-28 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
Please comment or provide details below to improve the information on DR. MARY MADISON EAGLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.