Active NPI
Mallory Diane Whalen, O.D.
- Optometrist
- New Braunfels, TX
National Provider Identifier
1154871648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 8919T
- Practice address
- 267 Creekside Way
New Braunfels, TX 78130-6389 - Phone
- (830) 387-7511
- Fax
- (830) 620-9419
- NPI assigned
- Oct 7, 2016
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 8919T | TX | Primary |
Addresses
Primary practice location
267 Creekside Way
New Braunfels, TX 78130-6389
Mailing address
267 Creekside Way
New Braunfels, TX 78130-6389
Phone (830) 387-7511
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 |
|---|---|---|---|
| 8919T | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1154871648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 CREEKSIDE WAY",
"city": "NEW BRAUNFELS",
"state": "TX",
"postal_code": "781306389",
"telephone_number": "830-387-7511",
"fax_number": "830-620-9419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 CREEKSIDE WAY",
"city": "NEW BRAUNFELS",
"state": "TX",
"postal_code": "781306389",
"telephone_number": "830-387-7511",
"fax_number": "830-620-9419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHALEN",
"first_name": "MALLORY",
"middle_name": "DIANE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-07",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "8919T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Braunfels, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.