Mary Leslie Womack, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23334 Issued in TX

Practice address

1000 FM 300
Levelland, TX 79336-6235

Phone

(806) 894-7842

Fax

(806) 894-3378

NPI assigned

Apr 12, 2007

Last updated

Jun 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Plains Rural Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Levelland, TX
  • NPI 1295746402
  Medicare reassignment NPD
• South Plains Rural Health Services, Inc.

  dba Howard County Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Big Spring, TX
  • NPI 1609171149
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1407070196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 FM 300",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "793366235",
            "telephone_number": "806-894-7842",
            "fax_number": "806-300-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 FM 300",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "793366235",
            "telephone_number": "806-894-7842",
            "fax_number": "806-894-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "MARY",
        "middle_name": "LESLIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198464309",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores Texas, LP (Vision Center 30-1051)
• Harry Talmadge Weaver Jr., MD
• West Texas Optimal Health
• Suvipa Wiri, MD
• Weerachai Wiri, MD
• Melissa S Wood, MS, LPC
• Shawnda Wood
• Monica Zanconato Campitruz

• General Practice Dentistry in Levelland, TX
• Providers in Levelland, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.