Individual provider Active NPI

Mary Christine Talatala, APRN - CNP

  • Nurse Practitioner
  • Bedford, TX
National Provider Identifier
1992691323
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1171343 Issued in TX
Practice address
2425 Highway 121
Bedford, TX 76021-5011
Phone
(817) 540-4477
Fax
(817) 540-5633
NPI assigned
Jun 13, 2025
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1171343 TX
Nurse Practitioner 363L00000X 1171343 TX Primary

Addresses

Primary practice location

2425 Highway 121
Bedford, TX 76021-5011

Mailing address

2425 Highway 121
Bedford, TX 76021-5011
Phone (817) 540-4447

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
I20250901000712 TX Practitioner - Nurse Practitioner 5597266437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2425 Hwy 121
Bedford, TX 76021-5013
Phone (817) 540-4477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1171343TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Interventional Pain Management, P.L.L.C CurrentSince Jun 20, 2025 Accepting new patients
Premier Interventional Pain Management, P.L.L.C CurrentSince Jun 20, 2025 Accepting new patients

Locations

2321 Olympia Dr
Ste 100A
Flower Mound, TX 75028
Phone (972) 350-0225

3001 Cross Timbers Rd
#120
Flower Mound, TX 75028
Phone (972) 350-0225

13080 Dallas Pkwy
Ste 310
Frisco, TX 75033
Phone (469) 269-1060

5605 Virginia Pkwy
Ste 3
McKinney, TX 75071
Phone (469) 452-2024

990 S Sherman St
Richardson, TX 75081
Phone (972) 788-0350

2118 E State Highway 114
Southlake, TX 76092
Phone (817) 488-0410

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1992691323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 HIGHWAY 121",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215011",
            "telephone_number": "817-540-4447",
            "fax_number": "817-540-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 HIGHWAY 121",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215011",
            "telephone_number": "817-540-4477",
            "fax_number": "817-540-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALATALA",
        "first_name": "MARY CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "APRN - CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1171343",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1171343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.