Individual
DENISE CHANELLE MAYO-WALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4200 TWELVE OAKS DR, HOUSTON, TX 77027-6812
(713) 621-5010
Mailing address
5120 WOODWAY DR, SUITE 7012, HOUSTON, TX 77056-1723
(713) 783-1536
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
P3389
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304886001
—
TX
05
—
304886002
—
TX
01
—
8DL522
BLUE CROSS BLUE SHIELD
TX
01
—
P01163091
RAILROAD MEDICARE
TX
Enumeration date
05/19/2008
Last updated
08/11/2015
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