Provider Demographics
NPI:1063475903
Name:MCCOY, DEVIN KEITH (PA)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:KEITH
Last Name:MCCOY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 COIT RD STE 104
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6171
Mailing Address - Country:US
Mailing Address - Phone:970-985-2797
Mailing Address - Fax:972-985-4797
Practice Address - Street 1:1600 COIT RD STE 104
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075
Practice Address - Country:US
Practice Address - Phone:972-985-2797
Practice Address - Fax:972-985-4797
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03342363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89N709OtherBCBS OF TEXAS
TXP52544Medicare UPIN
TX970025821Medicare PIN
TX970025821Medicare PIN