Individual ProviderAshley MackPediatricsAllopathic & Osteopathic PhysiciansPractice Address1935 Medical District Dr, Dallas, TX 75235-7701(844) 424-4537PECOS EnrollmentBased on the most recent information from CMS, provider Ashley Mack is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 10:37 AM.Profile DetailsProvider ID1639798614Provider TypeIndividualFull NameMack, AshleyGenderFemaleSole ProprietorNoEnumeration Date4/10/2020Last Updated12/31/2024Contact InformationPractice LocationPractice Address1935 Medical District Dr, Dallas, TX 75235-7701Phone(844) 424-4537FaxUnlisted FaxMailing LocationMailing Address625 19th St S, Birmingham, AL 35233-1900PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseU4857TexasCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer