Provider Demographics
NPI:1659699007
Name:MCCRARY, DEE GORDON III (DPM)
Entity Type:Individual
Prefix:DR
First Name:DEE
Middle Name:GORDON
Last Name:MCCRARY
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8304 INSPIRATION LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-8599
Mailing Address - Country:US
Mailing Address - Phone:903-454-8111
Mailing Address - Fax:903-455-8001
Practice Address - Street 1:4101 WESLEY ST STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-5635
Practice Address - Country:US
Practice Address - Phone:903-454-8111
Practice Address - Fax:903-455-8001
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-10
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2403213E00000X
MD01514213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005479OtherBCBS PROVIDER PAR