Provider Demographics
NPI:1225098957
Name:MCMAHON, STEPHEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:R
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 ED HALL DR
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-1861
Mailing Address - Country:US
Mailing Address - Phone:972-932-7349
Mailing Address - Fax:972-932-7273
Practice Address - Street 1:850 ED HALL DR
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1861
Practice Address - Country:US
Practice Address - Phone:972-932-7349
Practice Address - Fax:972-932-7273
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6514207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX680016195OtherMEDICARE RAILROAD
TX156329802Medicaid
TX156329801Medicaid
TX680016195OtherMEDICARE RAILROAD
TX156329801Medicaid