Provider Demographics
NPI:1649245754
Name:CAIRE, MARY L (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:CAIRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9720 COIT RD # 220-262
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5833
Mailing Address - Country:US
Mailing Address - Phone:214-619-5425
Mailing Address - Fax:214-619-5427
Practice Address - Street 1:5575 WARREN PKWY
Practice Address - Street 2:SUITE 304
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4062
Practice Address - Country:US
Practice Address - Phone:214-619-5425
Practice Address - Fax:214-619-5427
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3256208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160144502Medicaid
TX8M0250OtherBCBS
TX8B8341Medicare PIN
TX160144502Medicaid