Mary Wilson, RD in Southlake, TX - Medicare Dietitian, Registered Provider

Mary Wilson, RD is a medicare enrolled "Dietitian, Registered" provider in Southlake, Texas. Her current practice location is 620 E Southlake Blvd, Southlake, Texas. You can reach out to her office (for appointments etc.) via phone at (214) 623-6270.

Mary Wilson is licensed to practice in Texas (license number 86151599) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1366115461.

Contact Information

	Mary Wilson, RD
	620 E Southlake Blvd, Southlake, TX 76092-6236
	(214) 623-6270
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mary Wilson
Gender	Female
Speciality	Dietitian, Registered
Location	620 E Southlake Blvd, Southlake, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1366115461
Provider Enumeration Date: 07/26/2021
Last Update Date: 07/26/2021

Medicare PECOS Information:

PECOS PAC ID: 8820478928
Enrollment ID: I20220707001077

Medical Identifiers

Medical identifiers for Mary Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366115461	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	86151599 (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mary Wilson allows following entities to bill medicare on her behalf.

Provider Name	Texas Digestive Disease Consultants Pllc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1053397331 PECOS PAC ID: 3375531379 Enrollment ID: O20040505001844

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary Wilson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mary Wilson, RD 620 E Southlake Blvd, Southlake, TX 76092-6236 Ph: (214) 623-6270	Mary Wilson, RD 620 E Southlake Blvd, Southlake, TX 76092-6236 Ph: (214) 623-6270

Reviews and Comments

Dietitian, Registered in Southlake, TX

Jessica Julstedt Coffee, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1209 Timber Ct, Southlake, TX 76092 Phone: 817-366-4643
Mrs. Kara (rae) Rae Boswell, MS, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 630 N Kimball Ave Ste 110, Southlake, TX 76092 Phone: 972-422-9180
Janice May, RDN, LD, CDE Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1047 Summerplace Ln, Southlake, TX 76092 Phone: 817-905-7722
Anne-marie Alford, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 771 E Southlake Blvd Ste 106, Southlake, TX 76092 Phone: 469-372-2022 Fax: 833-290-5413
Dr. Diane Bentley Rollins, PH.D., R.D., L.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1614 Heatherbrook Ct, Southlake, TX 76092 Phone: 817-481-5971
Kelly King, RD, LD, CDCES Dietitian Medicare: Not Enrolled in Medicare Practice Location: 200 N Kimball Ave Ste 221, Southlake, TX 76092 Phone: 817-518-7239

Mary Wilson, RD - Medicare Dietitian in Southlake, TX