Provider Demographics
NPI:1043316078
Name:MAHANEY, JOE TEMPLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:TEMPLE
Last Name:MAHANEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3723 SUNSHINE RANCH RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-2510
Mailing Address - Country:US
Mailing Address - Phone:210-733-9537
Mailing Address - Fax:
Practice Address - Street 1:5788 ECKHERT RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3900
Practice Address - Country:US
Practice Address - Phone:210-699-2119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE44962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J7600Medicare PIN