Mallory, Brady

Mallory, Brady is an individual health care provider with primary practice located at 1940 East Hwy 114 Suite 150 , Southlake TX 76092. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Mallory, Brady can be contacted via phone (817) 424-3668.

Contact Information

Primary practice address
1940 East Hwy 114 Suite 150 Southlake TX 76092
Phone: (817) 424-3668
Fax: (817) 442-8637
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X SC006356 Pennsylvania
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X SC006356 Pennsylvania

Profile Details

NPI number 1992069777
LBN Legal business name Mallory, Brady
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2012
Last updated Dec 13th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992069777 NPPES
Texas Other 1932493574 NPI

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