Provider Demographics
NPI:1235132432
Name:MCCARTY, MATTHEW F (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:F
Last Name:MCCARTY
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 1:5200 DAVIS LANE
Mailing Address - Street 2:STE B200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749
Mailing Address - Country:US
Mailing Address - Phone:512-834-4141
Mailing Address - Fax:512-834-4142
Practice Address - Street 1:5200 DAVIS LANE
Practice Address - Street 2:STE B200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749
Practice Address - Country:US
Practice Address - Phone:512-834-4141
Practice Address - Fax:512-834-4142
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0615207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130285308Medicaid
TX37-1564010OtherTAX ID
TX8BD570OtherBCBS INDIVIDUAL #
TX8F7963OtherMEDICARE PTAN
TXTXB137878OtherMEDICARE PTAN - MARBLE FALLS
E02181Medicare UPIN
TX8F7963Medicare PIN