BRADY MALLORY (NPI# 1992069777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992069777 |
| Entity Type | Individual |
| Full Name | BRADY MALLORY |
| Credential | D.P.M. |
| Practice Address |
1940 East Hwy 114 Suite 150 Southlake TX 76092 |
| Mailing Address |
1940 Hwy 114 Suite 150 Southlake TX 76092 |
| Practice Telephone | 8174243668 |
| Practice Fax Number | 8174428637 |
| Mailing Telephone | 8174243668 |
| Mailing Fax Number | 8174428637 |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2016-12-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
SC006356 | PA | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
SC006356 | PA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | NPI | 1932493574 | 01 |
| Street Address |
1940 EAST HWY 114 SUITE 150 |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881695278 | Charleen Marie Handzel | Podiatrist | 1422 Main St, Suite 249, Southlake, TX 76092-7625 | 2005-08-09 |
| 1427057348 | Greg Jack Amelung | Podiatrist | 1940 E Highway 114 Ste 150, Southlake, TX 76092-6526 | 2005-07-21 |
| 1942220470 | Feet Feet, PC | Podiatrist | 1422 Main St, Ste 249, Southlake, TX 76092-7625 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748656 | Lonestar Foot and Ankle Surgical Associates, Pllc | Podiatrist | 515 E Court St Ste 300, Seguin, TX 78155-5726 | 2020-10-19 |
| 1528665437 | New Horizon Foot and Ankle Specialists | Podiatrist | 2448 Highway 121, Unit 808, Bedford, TX 76021-7317 | 2020-10-04 |
| 1467067603 | Katy Foot & Ankle Pllc | Podiatrist | 21660 Kingsland Blvd # 500, Katy, TX 77450-2511 | 2020-09-14 |
| 1154932812 | Delara Foot and Ankle Pllc | Podiatrist | 1604 Hospital Pkwy Ste 309, Bedford, TX 76022-6931 | 2020-08-14 |
| 1245858265 | Biel Foot & Ankle Specialists Pllc | Podiatrist | 19002 Park Row, Suite 100, Houston, TX 77084 | 2020-07-07 |
| 1013536952 | Select Foot and Ankle Specialists, P.l.l.c. | Podiatrist | 25222 Northwest Fwy Apt 185, Cypress, TX 77429-1038 | 2020-04-10 |
| 1871129445 | Interventional Partners LLC | Podiatrist | 17189 I 45 S Ste 285, Shenandoah, TX 77385-3320 | 2020-03-16 |
| 1073149647 | Interventional Partners LLC | Podiatrist | 18300 Katy Fwy Ste 235, Houston, TX 77094-1521 | 2020-03-16 |
| 1053947622 | Interventional Partners LLC | Podiatrist | 915 Gessner Rd Ste 380, Houston, TX 77024-2519 | 2020-03-16 |
| 1245866813 | Interventional Partners LLC | Podiatrist | 18220 Tomball Pkwy Ste 220, Houston, TX 77070-4370 | 2020-03-16 |
| Find all providers with the same taxonomy | ||||
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| 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.