Provider Demographics
NPI:1154453264
Name:MCCABE, PATRICK GERARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:GERARD
Last Name:MCCABE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N LOOP 1604 W
Mailing Address - Street 2:#118
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-4500
Mailing Address - Country:US
Mailing Address - Phone:210-492-8335
Mailing Address - Fax:210-479-5620
Practice Address - Street 1:1150 N LOOP 1604 W
Practice Address - Street 2:#118
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-4500
Practice Address - Country:US
Practice Address - Phone:210-492-8335
Practice Address - Fax:210-479-5620
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX180651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice