Provider Demographics
NPI:1568507283
Name:MCGAUGHEY, MILDRED GAYLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILDRED
Middle Name:GAYLE
Last Name:MCGAUGHEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 88361
Mailing Address - Street 2:CITY OF HOUSTON HEALTH & HUMAN SERVICES
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77288-8861
Mailing Address - Country:US
Mailing Address - Phone:713-794-9104
Mailing Address - Fax:713-798-0803
Practice Address - Street 1:5602 LYONS AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020
Practice Address - Country:US
Practice Address - Phone:713-671-3024
Practice Address - Fax:713-671-3002
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13915122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist