Mary Alexandra Landry, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04319 Issued in TX

Practice address

8112 Spring Valley Rd
Dallas, TX 75240-3829

Phone

(214) 884-1705

Fax

(214) 884-1711

NPI assigned

Sep 10, 2009

Sex

Female

Sole proprietor

Yes

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.landry.1@20514.direct.athenahealth.com

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.

• Health Express Clinics Network PLLC

  • Clinic/Center
  • Carrollton, TX
  • NPI 1164888632
  Medicare reassignment NPD
• HP Health & Wellness PLLC

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1578952800
  NPD
• Topcare Medical Group Inc

  • Specialist
  • Dallas, TX
  • NPI 1730337163
  NPD (past)
• Topcare Medical PA

  • Specialist
  • Irving, TX
  • NPI 1043231400
  NPD (past)

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296172800000",
    "number": "1609109552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E JOHN CARPENTER FWY",
            "address_2": "SUITE 850",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750622727",
            "telephone_number": "972-957-3000",
            "fax_number": "972-957-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8112 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752403829",
            "telephone_number": "214-884-1705",
            "fax_number": "214-884-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "MARY",
        "middle_name": "ALEXANDRA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2011-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA04319",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Landmark Radiation Dallas LP
• Payton Elayne Landrum, LPC-A
• Stephanie Landrum
• Landry Staffing Solutions
• Christine Susan Landry, MD
• Jessica Tillie Landson, PA-C
• Callie Ann Landwehr, MSN, APRN, FNP-C
• Lane Chiropractice Clinic, PC
• Lane Ogden, PH.D., PLLC
• Lane Weight Management LLC

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; 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.