Provider Demographics
NPI:1477539757
Name:MCMAHON, TERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:
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:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-5865
Mailing Address - Country:US
Mailing Address - Phone:806-743-2800
Mailing Address - Fax:806-743-4250
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:SUITE 1C102
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-2800
Practice Address - Fax:806-743-1668
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF05792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119162101OtherFIRSTCARE COMMERCIAL
TX124688604Medicaid
TX80917ZOtherHMO BLUE
NMA218OtherTRIWEST
TX124688602Medicaid
NMV3751Medicaid
TX89C398OtherBC/BS
TX119162100Medicaid
OK100088650AMedicaid