Provider Demographics
NPI:1578668638
Name:MCMAHON, LINDA K (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5812 BRIDLE BEND TRL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4529
Mailing Address - Country:US
Mailing Address - Phone:972-248-6204
Mailing Address - Fax:
Practice Address - Street 1:39 ARAPAHO VILLAGE CTR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5001
Practice Address - Country:US
Practice Address - Phone:972-680-9717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX23739Medicare ID - Type Unspecified