Provider Demographics
NPI:1639261720
Name:MCGAHEE, ROY WAYNE (RT)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:WAYNE
Last Name:MCGAHEE
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 FARM ROAD 2297
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-4719
Mailing Address - Country:US
Mailing Address - Phone:903-439-6085
Mailing Address - Fax:903-439-0462
Practice Address - Street 1:472 FARM ROAD 2297
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-4719
Practice Address - Country:US
Practice Address - Phone:903-439-6085
Practice Address - Fax:903-439-0462
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR20353247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086092601Medicaid
TX086092601Medicaid
TX630000634Medicare PIN