Wayne Gale Mulloy, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C7717 Issued in TX

Practice address

15035A East Frwy
Channelview, TX 77530

Phone

(281) 452-5829

Fax

(281) 457-6749

NPI assigned

Jun 29, 2006

Last updated

May 29, 2008By the provider in NPPES

Sex

Male

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

Other names 1

• Mrs. Loretta L Gant Other name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1932137908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15035A EAST FRWY",
            "city": "CHANNELVIEW",
            "state": "TX",
            "postal_code": "77530",
            "telephone_number": "281-452-5829",
            "fax_number": "281-457-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15035A EAST FRWY",
            "city": "CHANNELVIEW",
            "state": "TX",
            "postal_code": "77530",
            "telephone_number": "281-452-5829",
            "fax_number": "281-457-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLOY",
        "first_name": "WAYNE",
        "middle_name": "GALE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "C7717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010011881",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORETTA",
            "last_name": "GANT",
            "middle_name": "L",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ryan McFarland, OTR
• Med Assis Transport
• Melvin M Thomas PLLC
• Jenefer Moore, PHYSICAL THERAPIST
• Brittanee Morris, LPC
• John T Nguyen, DDS
• Donald R Nino, MD
• Jennifer Norris, CNC, CPT, MASTER T.
• Vane Ocharo, FNP-C
• Obio Offong

• Family Medicine Physician in Channelview, TX
• Providers in Channelview, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.