Provider Demographics
NPI:1447598693
Name:MERRICK MCMAINS, MD, PA
Entity Type:Organization
Organization Name:MERRICK MCMAINS, MD, PA
Other - Org Name:LONGHORN PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMAINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-236-9306
Mailing Address - Street 1:2911 MEDICAL ARTS ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3376
Mailing Address - Country:US
Mailing Address - Phone:512-236-9306
Mailing Address - Fax:
Practice Address - Street 1:2911 MEDICAL ARTS ST
Practice Address - Street 2:SUITE 20
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3376
Practice Address - Country:US
Practice Address - Phone:512-236-9306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty