Provider Demographics
NPI:1609173855
Name:MCWHIRTER, PAUL DOUGLAS
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DOUGLAS
Last Name:MCWHIRTER
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:DOUGLAS
Other - Last Name:MCWHIRTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:MAURICEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77626-0687
Mailing Address - Country:US
Mailing Address - Phone:409-670-5914
Mailing Address - Fax:936-632-9602
Practice Address - Street 1:531 GASLIGHT BLVD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3127
Practice Address - Country:US
Practice Address - Phone:409-670-5914
Practice Address - Fax:936-632-9602
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX407591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical