Individual
MICHAEL J. MCMAINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1207 BROOKLYN AVE, SAN ANTONIO, TX 78212-4804
(210) 472-2090
(210) 472-2062
Mailing address
1419 BROOK MDWS, SAN ANTONIO, TX 78232-5151
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
21260
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87217A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/30/2006
Last updated
07/08/2007
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