Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | M6284 | TX |
N | 2081S0010X | Sports Medicine | M6284 | TX |
N | 213ES0000X | Sports Medicine | M6284 | TX |
NPI | 1285829176 |
---|---|
Provider Name | Aine P Mckenzie |
First Address | Plano, TX 75093-5619 |
Second Address | Plano, TX 75093-5619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2007 |
Last Update Date | 01/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8CR154 | BCBS TX 02/01/2011 (01) | TX |
M6284 | TEXAS MEDICAL BOARD (01) | TX |
P00913355 | MEDICARE RAILROAD - EFFECT 02/01/2011 (01) | TX |
TXB117532 | MEDICARE PART B - EFFECT 02/01/2011 (01) | TX |