Provider Demographics
NPI:1548240641
Name:MCMAHON, MICHAEL LLOYD II (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LLOYD
Last Name:MCMAHON
Suffix:II
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 1:2940 SPURLOCK RD
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1003 NEDERLAND AVE
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-2832
Practice Address - Country:US
Practice Address - Phone:409-344-4466
Practice Address - Fax:409-600-8525
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0347207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111926504Medicaid
TX8F0720Medicare ID - Type Unspecified
TX111926504Medicaid