Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | J0109 | TX |
N | 207YP0228X | Pediatric Otolaryngology | J0109 | TX |
NPI | 1053379370 |
---|---|
Provider Name | John Eric Mcclay |
First Address | Dallas, TX 75373-3784 |
Second Address | Frisco, TX 75033-4255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103431602 | (05) | TX |
F18200 | (02) |