Provider Demographics
NPI:1407841232
Name:APPLEBY, MARY A
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:APPLEBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12225 GREENVILLE AVE
Mailing Address - Street 2:STE 450
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2064
Mailing Address - Country:US
Mailing Address - Phone:214-342-1600
Mailing Address - Fax:214-342-1603
Practice Address - Street 1:9301 N CENTRAL EXPY STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0804
Practice Address - Country:US
Practice Address - Phone:214-636-0761
Practice Address - Fax:972-241-4944
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100131225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX653005Medicare PIN