Active NPI
Estine Michelle Mallett
- Contractor
- Irving, TX
National Provider Identifier
1790443174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 801 W Irving Blvd
Irving, TX 75060-2845 - Phone
- (870) 489-2692
- NPI assigned
- Dec 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
801 W Irving Blvd
Irving, TX 75060-2845
Mailing address
621 Green Meadows LN
Ovilla, TX 75154-1474
Phone (870) 489-2692
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1790443174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 GREEN MEADOWS LN",
"city": "OVILLA",
"state": "TX",
"postal_code": "751541474",
"telephone_number": "870-489-2692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 W IRVING BLVD",
"city": "IRVING",
"state": "TX",
"postal_code": "750602845",
"telephone_number": "870-489-2692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLETT",
"first_name": "ESTINE",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-02",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.