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General NPI Number Information
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NPI Number | 1770377202
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Entity Type | Individual
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Provider Name | MALLORY LOUISE POTTS DC
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Gender | Female
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 225 S COMMONS FORD RD
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City | AUSTIN
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State | TX
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Zip | 78733-4004
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Country | US
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Telephone | 512-524-5292
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Fax |
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Provider Business Mailing Address
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Address Line | 5313 VEGA AVE APT 3204
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City | AUSTIN
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State | TX
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Zip | 78735-5820
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Country | US
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Telephone | 210-386-2636
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 16324
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License Number State | TX
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