Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Wisbon, MD

Individual provider Pediatrics Physician · NPI 1770110124

Mary Wisbon, MD is a Pediatric Medicine in Houston, Texas. Graduated from University of New Mexico School of Medicine in 2020, 6 years ago. Practices with Texas Childrens Physician Group, a 655-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
6
Trained at
University of New Mexico School of Medicine
Licensed in
TX
In the registry since
2020
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6621 Fannin St
Houston, TX 77030-2358
Phone: (832) 824-1170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Emergency Medicine (Pediatrics) Physician (primary) Taxonomy 2080P0204X · Licence U3382 (TX)
Pediatrics Physician Taxonomy 208000000X · Licence U3382 (TX)

Record details

NPI number1770110124
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 25, 2020
Last updated in NPPESJuly 2, 2026
Certification dateJuly 2, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolUNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Texas Childrens Physician Group — 655 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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