Individual provider Active NPI

Mary Walsh

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1700619319
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA20085 Issued in TX
Practice address
6720 Bertner Ave
Houston, TX 77030-2604
Phone
(713) 798-1000
NPI assigned
Aug 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20085 TX
Surgical Physician Assistant 363AS0400X PA20085 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

6720 Bertner Ave
Houston, TX 77030-2604

Mailing address

1518 Columbia St
Houston, TX 77008-4535
Phone (703) 789-5600

Other practice location 1

1462 Clifton Rd NE Ste 280
Atlanta, GA 30322-1063
Phone (404) 727-7825

Other practice location 2

1977 Butler Blvd
Houston, TX 77030-4101
Phone (713) 798-5841

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260526003837 TX Practitioner - Physician Assistant 5698245124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Baylor PLZ
2Gr900
Houston, TX 77030-3498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA20085TXMDSurgical Physician Assistant

Organizations & group practices 1

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": "1724198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1700619319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 COLUMBIA ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770084535",
            "telephone_number": "703-789-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 BERTNER AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "713-798-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1462 Clifton Rd NE Ste 280",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221063",
            "country_code": "US",
            "telephone_number": "404-727-7825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1977 Butler Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304101",
            "country_code": "US",
            "telephone_number": "713-798-5841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-21",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA20085",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA20085",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.