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BRADY MALLORY D.P.M.
NPI 1992069777
Podiatrist - Foot & Ankle Surgery in Southlake, TX

Active since June 27, 2012
1940 EAST HWY 114 SUITE 150, SOUTHLAKE, TX 76092(817) 424-3668(817) 442-8637 Get Directions Write a Review

NPPES record last updated: December 13, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Brady Mallory D.p.m. NPPES

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

BRADY MALLORY D.P.M. (NPI 1992069777) is an individual foot & ankle surgery provider in Southlake, Texas, licensed in Pennsylvania (SC006356) and active in the NPI registry since June 2012.

NPPES Registry Identity

NPI1992069777
Entity TypeIndividualMale
Primary Taxonomy213ES0103X
Provider Legal NameBRADY MALLORYCredential: D.P.M.
Location Address1940 EAST HWY 114 SUITE 150Southlake, TX 76092
Mailing Address1940 Hwy 114 Suite 150Southlake, TX 76092 · (817) 424-3668 · Fax (817) 442-8637
Phone(817) 424-3668
Fax(817) 442-8637
Sole ProprietorNo
Enumeration DateJune 27, 2012
Last NPPES UpdateDecember 13, 2016
✔ NPI 1992069777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in PA · SC006356
Also ListedPodiatrist · Primary Podiatric MedicineTaxonomy 213EP1101X · License SC006356 (PA)
1940 EAST HWY 114 SUITE 150, Southlake, TX 76092
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Other Identifiers 3

Other812618080TX · Tin
Other1932493574TX · Npi
Other900170193TX · Tin

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 Brady Mallory's NPI number?

The NPI number for Brady Mallory is 1992069777. It was assigned to this individual provider in the NPPES registry on June 27, 2012.

Where is Brady Mallory located?

Brady Mallory practices at 1940 East Hwy 114 Suite 150, Southlake, TX 76092. The listed phone number is (817) 424-3668.

What is Brady Mallory's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

When was this NPI record last updated?

The NPPES record for Brady Mallory was last updated on December 13, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.