Individual provider Active NPI

Maelyn Dishman, PAC

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1740520436
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA07934 Issued in TX
Practice address
10425 Huffmeister Rd Ste 210
Houston, TX 77065-3429
Phone
(281) 890-0911
NPI assigned
Feb 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA07934 TX Primary

Addresses

Primary practice location

10425 Huffmeister Rd Ste 210
Houston, TX 77065-3429

Mailing address

7215 Palisades Heights Dr
Houston, TX 77095-2545
Phone (812) 599-5070

Other identifiers 2

IdentifierTypeStateIssuer
00889NOtherTXMEDICARE PTAN
279741Y862OtherTXMEDICARE PROVIDER NUMBER

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA07934TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Irvin J. Saron, M.D., PA CurrentSince Jan 7, 2024 Accepting new patients

Locations

21216 Northwest Fwy
Ste 440
Cypress, TX 77429
Phone (281) 664-2101

10425 Huffmeister Rd
Ste 210
Houston, TX 77065
Phone (281) 890-0911

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": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1740520436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7215 PALISADES HEIGHTS DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770952545",
            "telephone_number": "812-599-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10425 HUFFMEISTER RD STE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653429",
            "telephone_number": "281-890-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISHMAN",
        "first_name": "MAELYN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA07934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00889N",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "279741Y862",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.

Verify at the official NPI Registry.