Individual provider Active NPI

Paul Alan Mabry, M.D.

  • Family Medicine Physician
  • Sherman, TX
National Provider Identifier
1457322208
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H2549 Issued in TX
Practice address
809 Gallagher Dr Ste D
Sherman, TX 75090-1754
Phone
(903) 771-2846
Fax
(037) 712-8499
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H2549 TX Primary

Addresses

Primary practice location

809 Gallagher Dr Ste D
Sherman, TX 75090-1754

Mailing address

809 Gallagher Dr Ste D
Sherman, TX 75090-1754
Phone (903) 771-2846

Other practice location 1

Office of the State Surgeon
Bldg. 40-4, Watervliet Arsenal
Watervliet, NY 12189-4050
Phone (518) 796-4598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190923002940 TX Practitioner - Family Practice 4082625264 Reassigns benefits to 1 organization
I20241205003511 GA Practitioner - Family Practice 4082625264 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H2549TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galileo Medical Group Ga, P.C. Family Medicine CurrentSince Aug 10, 2024 Accepting new patients
Grayson County Health Clinic CurrentSince Jul 1, 2019 Accepting new patients

Locations

4300 Paces Ferry Rd SE
Ste 500
Atlanta, GA 30339
Phone (404) 496-8960

64 Bleecker St
New York, NY 10012
Phone (302) 313-1584

809 Gallagher Dr
Ste D
Sherman, TX 75090
Phone (903) 771-2846

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: paul.mabry@450368864321540.direct.elationemr.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIEDCA

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1457322208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 GALLAGHER DR STE D",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901754",
            "telephone_number": "903-771-2846",
            "fax_number": "037-712-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 GALLAGHER DR STE D",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901754",
            "telephone_number": "903-771-2846",
            "fax_number": "037-712-8499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Office of the State Surgeon",
            "address_2": "Bldg. 40-4, Watervliet Arsenal",
            "address_purpose": "LOCATION",
            "city": "Watervliet",
            "state": "NY",
            "postal_code": "121894050",
            "country_code": "US",
            "telephone_number": "518-796-4598",
            "fax_number": "518-796-4420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MABRY",
        "first_name": "PAUL",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H2549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

Verify at the official NPI Registry.