Healthcare Provider Details
I. General information
NPI: 1568378693
Provider Name (Legal Business Name): RENEE MAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1931 FM 423 STE 500
FRISCO TX
75033-0361
US
IV. Provider business mailing address
2336 OPALINE DR
LITTLE ELM TX
76227-3070
US
V. Phone/Fax
- Phone: 972-900-0546
- Fax:
- Phone: 972-900-0546
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: