Provider Demographics
NPI:1093989048
Name:MATTHEW F MCCARTY MD PLLC
Entity Type:Organization
Organization Name:MATTHEW F MCCARTY MD PLLC
Other - Org Name:BALCONES PAIN CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-834-4141
Mailing Address - Street 1:5200 DAVIS LN
Mailing Address - Street 2:STE B200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-4064
Mailing Address - Country:US
Mailing Address - Phone:512-834-4141
Mailing Address - Fax:512-834-4142
Practice Address - Street 1:5200 DAVIS LN
Practice Address - Street 2:STE B200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-4064
Practice Address - Country:US
Practice Address - Phone:512-834-4141
Practice Address - Fax:512-834-4142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0615207L00000X, 207LP2900X
TX363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0081RDOtherBCBS GRP #
TX200143001Medicaid
TX200143001Medicaid