Provider Demographics
NPI:1013201854
Name:TODD MCCARTY, MD, PA
Entity Type:Organization
Organization Name:TODD MCCARTY, MD, PA
Other - Org Name:LAKEWOOD WEIGHT LOSS AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-547-6170
Mailing Address - Street 1:8824 ANTRIM DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3902
Mailing Address - Country:US
Mailing Address - Phone:469-547-6170
Mailing Address - Fax:469-547-6180
Practice Address - Street 1:9219 GARLAND RD
Practice Address - Street 2:SUITE 2107
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3697
Practice Address - Country:US
Practice Address - Phone:469-547-6170
Practice Address - Fax:469-547-6180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ0108OtherLICENSE#