Provider Demographics
NPI:1518964014
Name:MCMAINS, MERRICK JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:MERRICK
Middle Name:JAMES
Last Name:MCMAINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
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:512-236-9978
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:512-236-9978
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2011-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL8429208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164018704Medicaid
TX164018704Medicaid