Provider Demographics
NPI:1124022694
Name:MCGANITY, PETER L (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:L
Last Name:MCGANITY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8601 VILLAGE DR
Mailing Address - Street 2:STE 210
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5512
Mailing Address - Country:US
Mailing Address - Phone:210-654-8700
Mailing Address - Fax:210-654-8750
Practice Address - Street 1:8601 VILLAGE DR
Practice Address - Street 2:STE 210
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5512
Practice Address - Country:US
Practice Address - Phone:210-654-8700
Practice Address - Fax:210-654-8750
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-11
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE4515207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102920904OtherCSHCN
TX102920903Medicaid
TX102920903Medicaid
TX00228HMedicare PIN