# THERON GARRICK MCCORMICK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1649367541
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | 201441 | LA | — |
| 207K00000X | Allergy & Immunology Physician | L5832 | TX | — |
| 2080P0201X | Pediatric Allergy/Immunology Physician | 201441 | LA | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 02/05/2021