Active NPI
Marie Buckley, LDP
- Neurodevelopmental Disabilities Physician
- Dallas, TX
National Provider Identifier
1215783535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurodevelopmental Disabilities Physician
- License
- 1143
- Practice address
- 17950 Sunmeadow Dr Apt 4801
Dallas, TX 75252-5390 - Phone
- (602) 881-0528
- NPI assigned
- Apr 26, 2024
- Last updated
- Apr 26, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Neurodevelopmental Disabilities Physician | 2084P0005X | 1143 | TX | Primary |
Addresses
Primary practice location
17950 Sunmeadow Dr Apt 4801
Dallas, TX 75252-5390
Mailing address
17950 Sunmeadow Dr Apt 4801
Dallas, TX 75252-5390
Phone (602) 881-0528
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 |
|---|---|---|---|
| 1143 | TX | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714089600000",
"number": "1215783535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17950 SUNMEADOW DR APT 4801",
"city": "DALLAS",
"state": "TX",
"postal_code": "752525390",
"telephone_number": "602-881-0528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17950 SUNMEADOW DR APT 4801",
"city": "DALLAS",
"state": "TX",
"postal_code": "752525390",
"telephone_number": "602-881-0528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEY",
"first_name": "MARIE",
"credential": "LDP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-26",
"last_updated": "2024-04-26",
"certification_date": "2024-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0005X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
"state": "TX",
"license": "1143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
- Larita Buckhanas, LMT
- Linda Langford Buckins, RN, MSN, FNP-C
- Christopher Francis Xavier Buckley, DC
- Gloria L Buckley, AU.D., CCC-A
- Leia Kirch Buckley
- Brittany Ann Buckmaster, PA-C
- Buckner 30 Chiropractic Clinic, Inc.
- Buckner Children & Family Services
- Buckner Family Medical Association, PA (Patients Choice Family Medicine and Rehab)
- Buckner Market Place Dental, P.a. (Bear Creek Family Dentistry)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.