DR. MARY CHANDLER SELF M.D.
NPI 1053607853
Psychiatry & Neurology - Psychiatry in Houston, TX

Q: What is Mary Chandler Self's NPI number?

The NPI number for Mary Chandler Self is 1053607853. It was assigned to this individual provider in the NPPES registry on June 21, 2011.

Q: What is Mary Chandler Self's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: Is Mary Chandler Self enrolled in Medicare?

No. Mary Chandler Self has opted out of Medicare through February 15, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since June 21, 2011Opted out of Medicare · through Feb 15, 2028

104 W 12TH ST STE B, HOUSTON, TX 77008(972) 965-4232(972) 347-8109 Get Directions Write a Review

NPPES record last updated: January 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 20, 2026, Jan 2, 2024, Oct 29, 2018 and 1 more (4 updates tracked since 2017).

On this page

About Dr. Mary Chandler Self M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARY CHANDLER SELF M.D. (NPI 1053607853) is an individual psychiatry provider in Houston, Texas, licensed in Texas (R5315) and active in the NPI registry since June 2011. She has opted out of Medicare through February 15, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1053607853

Entity TypeIndividualFemale

Primary Taxonomy2084P0800X

Provider Legal NameDR. MARY CHANDLER SELFCredential: M.D.

Location Address104 W 12TH ST STE BHouston, TX 77008-6990

Mailing Address104 W 12th St Ste BHouston, TX 77008-6990 · (972) 965-4232 · Fax (972) 347-8109

Phone(972) 965-4232

Fax(972) 347-8109

Sole ProprietorNo

Enumeration DateJune 21, 2011

Last NPPES UpdateJanuary 20, 20264 updates tracked since enumeration

NPPES CertifiedJanuary 20, 2026

✔ NPI 1053607853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Licenses✔ Licensed in TX · R5315✔ Licensed in NY · 268156

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

104 W 12TH ST STE B, Houston, TX 77008

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Mary Chandler Self M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 15, 2024 through February 15, 2028.

Opt-Out Effective DateFebruary 15, 2024

Opt-Out In Effect ThroughFebruary 15, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77008 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$176.98 typical visit price

range $58.24 – $176.98

Typical copayment $44.24 (range $14.56 – $44.24)

Most-billed visit code 99205

Established Patient

$72.62 typical visit price

range $18.60 – $143.93

Typical copayment $18.15 (range $4.65 – $35.98)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MENTAL HEIGHTS, PLLC

Counselor (Mental Health)

104 W 12TH ST STE B
HOUSTON, TX 77008

Harris County (936) 900-1416

SHANA S TATUM RD

Dietitian, Registered

104 W 12TH ST STE B
HOUSTON, TX 77008

Harris County (713) 868-4372

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Chandler Self's NPI number?

The NPI number for Mary Chandler Self is 1053607853. It was assigned to this individual provider in the NPPES registry on June 21, 2011.

Where is Mary Chandler Self located?

Mary Chandler Self practices at 104 W 12th St Ste B, Houston, TX 77008. The listed phone number is (972) 965-4232.

What is Mary Chandler Self's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Mary Chandler Self enrolled in Medicare?

No. Mary Chandler Self has opted out of Medicare through February 15, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Mary Chandler Self was last updated on January 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.