Provider Demographics
NPI:1215381017
Name:MCCORMICK, STEVE
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:MCCORMICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 W AIRPORT FWY
Mailing Address - Street 2:STE 106
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-5902
Mailing Address - Country:US
Mailing Address - Phone:972-313-2543
Mailing Address - Fax:
Practice Address - Street 1:3401 W AIRPORT FWY
Practice Address - Street 2:STE 106
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5902
Practice Address - Country:US
Practice Address - Phone:972-313-2543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20244237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist