Provider Demographics
NPI:1831293281
Name:DEMELLIER, MARY FRANCES (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:FRANCES
Last Name:DEMELLIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 BISSONNET
Mailing Address - Street 2:SUITE 270
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2192
Mailing Address - Country:US
Mailing Address - Phone:713-666-1980
Mailing Address - Fax:713-668-6595
Practice Address - Street 1:3400 BISSONNET
Practice Address - Street 2:SUITE 270
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-2192
Practice Address - Country:US
Practice Address - Phone:713-666-1980
Practice Address - Fax:713-668-6595
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-2639103T00000X
TX001557-001610106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A46LMedicare ID - Type Unspecified