Active NPI
Mary Lee Brown Moody
- Community Health Worker
- Bastrop, TX
National Provider Identifier
1013889179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 13036
- Practice address
- 806 Water St
Bastrop, TX 78602-3832 - Phone
- (512) 296-0859
- NPI assigned
- Sep 19, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 13036 | TX | Primary |
Addresses
Primary practice location
806 Water St
Bastrop, TX 78602-3832
Mailing address
806 Water St
Bastrop, TX 78602-3832
Phone (512) 296-0859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13036 | TX | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758240000000",
"number": "1013889179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "806 WATER ST",
"city": "BASTROP",
"state": "TX",
"postal_code": "786023832",
"telephone_number": "512-296-0859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 WATER ST",
"city": "BASTROP",
"state": "TX",
"postal_code": "786023832",
"telephone_number": "512-296-0859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOODY",
"first_name": "MARY",
"middle_name": "LEE BROWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-19",
"last_updated": "2025-09-19",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "TX",
"license": "13036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bastrop, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.