Provider Demographics
NPI:1376589200
Name:MCCANN, DONALD C (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:C
Last Name:MCCANN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LYNN BATTS
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3078
Mailing Address - Country:US
Mailing Address - Phone:210-829-1994
Mailing Address - Fax:210-829-8788
Practice Address - Street 1:21 LYNN BATTS
Practice Address - Street 2:SUITE 11
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3078
Practice Address - Country:US
Practice Address - Phone:210-829-1994
Practice Address - Fax:210-829-8788
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-1328103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A8685Medicare ID - Type UnspecifiedMEDICARE NUMBER