Provider Demographics
NPI:1942836986
Name:ARINELLO, MALLORY PARRISH (PA-C)
Entity type:Individual
Prefix:
First Name:MALLORY
Middle Name:PARRISH
Last Name:ARINELLO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 APPLETON LN
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2932
Mailing Address - Country:US
Mailing Address - Phone:334-313-2210
Mailing Address - Fax:
Practice Address - Street 1:1110 COTTONWOOD LN STE 110
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6121
Practice Address - Country:US
Practice Address - Phone:447-897-2468
Practice Address - Fax:888-880-9323
Is Sole Proprietor?:No
Enumeration Date:2020-03-22
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA17981363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant