Provider Demographics
NPI:1538296645
Name:DOYLE, MARY ELIZABETH (DC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:DOYLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 890389
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77289-0389
Mailing Address - Country:US
Mailing Address - Phone:713-571-0622
Mailing Address - Fax:281-488-3022
Practice Address - Street 1:601 N AKARD ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-3303
Practice Address - Country:US
Practice Address - Phone:713-652-9777
Practice Address - Fax:281-488-3022
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4364683OtherAETNA ID
TX8S6610OtherBLUECROSS BLUESHIELD ID
TX7074319OtherCIGNA ID
TX8R9382OtherBLUECROSS BLUESHIELD ID
TX8178968OtherBLUELINK ID
TX602057Medicare ID - Type UnspecifiedMEDICARE ID
TX8178968OtherBLUELINK ID