Provider Demographics
NPI:1821034661
Name:MCCAFFREY, AMY JEAN (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JEAN
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11673 JOLLYVILLE RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3933
Mailing Address - Country:US
Mailing Address - Phone:512-338-5161
Mailing Address - Fax:512-338-5019
Practice Address - Street 1:11673 JOLLYVILLE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3933
Practice Address - Country:US
Practice Address - Phone:512-338-5161
Practice Address - Fax:512-338-5019
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5350207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG5350OtherSTATE LICENSE NUMBER
TXG5350OtherSTATE LICENSE NUMBER
00G952Medicare ID - Type Unspecified