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MARY ELISE WALLER PT, DPT
NPI 1649865692
Physical Therapist - Orthopedic in Southlake, TX

Active since March 02, 2021
2419 W SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092(469) 535-6842 Get Directions Write a Review

NPPES record last updated: March 2, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Elise Waller Pt, Dpt NPPES

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

MARY ELISE WALLER PT, DPT (NPI 1649865692) is an individual orthopedic provider in Southlake, Texas, licensed in Texas (1342742) and active in the NPI registry since March 2021.

NPPES Registry Identity

NPI1649865692
Entity TypeIndividualFemale
Primary Taxonomy2251X0800X
Provider Legal NameMARY ELISE WALLERCredential: PT, DPT
Location Address2419 W SOUTHLAKE BLVD STE 100Southlake, TX 76092-1506
Mailing Address5828 Colhurst StDallas, TX 75230-5020 · (214) 926-6041
Phone(469) 535-6842
Sole ProprietorNo
Enumeration DateMarch 2, 2021
NPPES CertifiedMarch 2, 2021
✔ NPI 1649865692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251X0800X
License✔ Licensed in TX · 1342742
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.
2419 W SOUTHLAKE BLVD STE 100, Southlake, TX 76092
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Other Providers at the Same Location NPPES 7

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

MICAH CHRISTIAN BOWMAN PA-C
Physician Assistant
2419 W SOUTHLAKE BLVD STE 100
SOUTHLAKE, TX 76092
Tarrant County (469) 535-6842
NIRANJAN KC PA-C
Physician Assistant
2419 W SOUTHLAKE BLVD STE 100
SOUTHLAKE, TX 76092
Tarrant County (469) 535-6842
BRITTANY PADGETT
Physician Assistant (Medical)
2419 W SOUTHLAKE BLVD STE 100
SOUTHLAKE, TX 76092
Tarrant County (469) 535-6842
DR. TRACEE SMITH MPT, DPT
Physical Therapist
2419 W SOUTHLAKE BLVD STE 100
SOUTHLAKE, TX 76092
Tarrant County (817) 809-2660
DOCTX3 PLLC
Clinic/Center
2419 W SOUTHLAKE BLVD STE 100
SOUTHLAKE, TX 76092
Tarrant County (817) 809-2660
LYNDSAY MARIE GARZA PA-C
Physician Assistant
2419 W SOUTHLAKE BLVD STE 100
SOUTHLAKE, TX 76092
Tarrant County (469) 535-6842
DR. ANDREW PAUL FREESE M.D.
Orthopaedic Surgery (Sports Medicine)
2419 W SOUTHLAKE BLVD STE 100
SOUTHLAKE, TX 76092
Tarrant County (817) 809-2660

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 Waller's NPI number?

The NPI number for Mary Waller is 1649865692. It was assigned to this individual provider in the NPPES registry on March 2, 2021.

Where is Mary Waller located?

Mary Waller practices at 2419 W Southlake Blvd Ste 100, Southlake, TX 76092. The listed phone number is (469) 535-6842.

What is Mary Waller's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

What insurance does Mary Waller accept?

Health plans from Molina Healthcare list Mary Waller as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Waller was last updated on March 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.