Provider Demographics
NPI:1306814447
Name:MCQUAID, KEVIN JAMES (MD)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:JAMES
Last Name:MCQUAID
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:PO BOX 841363
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1363
Mailing Address - Country:US
Mailing Address - Phone:888-276-2223
Mailing Address - Fax:214-596-7484
Practice Address - Street 1:6655 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2443
Practice Address - Country:US
Practice Address - Phone:214-277-8700
Practice Address - Fax:214-596-7484
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5832207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116808003Medicaid
TX116808004Medicaid
80P151Medicare ID - Type Unspecified
84P154Medicare ID - Type Unspecified
TX116808003Medicaid