Provider Demographics
NPI:1952604662
Name:MAYO, MONIQUE (DC/MT)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:
Last Name:MAYO
Suffix:
Gender:F
Credentials:DC/MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E US HIGHWAY 80 STE 170
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-8615
Mailing Address - Country:US
Mailing Address - Phone:972-357-7050
Mailing Address - Fax:800-249-4581
Practice Address - Street 1:104 E US HIGHWAY 80 STE 170
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-8615
Practice Address - Country:US
Practice Address - Phone:972-357-7050
Practice Address - Fax:800-249-4581
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX033885225700000X
TX14468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist