Organization
PRACTICAL PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W MCCOY M.D. (OWNER PEDIATRICAN)
(817) 481-3585
Entity
Organization
Contact information
Practice address
811 IRA E WOODS AVE., GRAPEVINE, TX 76051-4012
(817) 481-3585
(817) 421-6529
Mailing address
811 IRA E WOODS AVE, GRAPEVINE, TX 76051-8722
(817) 481-3585
(817) 421-6529
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H5589
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E56705
UPIN
TX
Enumeration date
12/03/2007
Last updated
12/03/2007
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