NPIMap

Organization Active NPI

Mary Kelly Green MD PLLC

  • Eyewear Supplier
  • Marble Falls, TX
National Provider Identifier
1790050698
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
MARY KELLY GREEN MD PLLC
Practice address
204 Gateway N
Suite C
Marble Falls, TX 78654-6361
Phone
(803) 693-3787
Fax
(803) 798-8012
NPI assigned
Mar 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Mary K. Green, MDNPI 1487835617
Title
Owner
Phone
(803) 693-3787

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X TX Primary

Addresses

Primary practice location

204 Gateway N
Suite C
Marble Falls, TX 78654-6361

Mailing address

204 Gateway N
Suite C
Marble Falls, TX 78654-6361
Phone (803) 693-3787

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1790050698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 GATEWAY N",
            "address_2": "SUITE C",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786546361",
            "telephone_number": "803-693-3787",
            "fax_number": "803-798-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 GATEWAY N",
            "address_2": "SUITE C",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786546361",
            "telephone_number": "803-693-3787",
            "fax_number": "803-798-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY KELLY GREEN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-693-3787",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marble Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.