Provider Demographics
NPI:1164287090
Name:MCDAVID M MAHAFFEY MD PA -GODLEY
Entity Type:Organization
Organization Name:MCDAVID M MAHAFFEY MD PA -GODLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTICING PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:MCDAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAHAFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-202-3976
Mailing Address - Street 1:805 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-3816
Mailing Address - Country:US
Mailing Address - Phone:817-202-3976
Mailing Address - Fax:817-202-3978
Practice Address - Street 1:109 E GODLEY AVE
Practice Address - Street 2:
Practice Address - City:GODLEY
Practice Address - State:TX
Practice Address - Zip Code:76044-3787
Practice Address - Country:US
Practice Address - Phone:662-289-0427
Practice Address - Fax:817-202-3978
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCDAVID M MAHAFFEY MD PA -GODLEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty