Organization
MCLEAN ORTHOPAEDICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ROY MCLEAN MD (OWNER)
(936) 560-2990
Entity
Organization
Contact information
Practice address
1300 N MOUND ST, NACOGDOCHES, TX 75961-4029
(936) 560-2990
Mailing address
PO BOX 632749, NACOGDOCHES, TX 75963-2749
(936) 560-2990
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E2718
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81K363
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/08/2007
Last updated
07/22/2010
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