Provider Demographics
NPI:1821320177
Name:MCAULIFF, TIMOTHY M (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:M
Last Name:MCAULIFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TIM
Other - Middle Name:
Other - Last Name:MCAULIFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5301 W SPRING CREEK PKWY APT 2234
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4912
Mailing Address - Country:US
Mailing Address - Phone:940-781-8642
Mailing Address - Fax:
Practice Address - Street 1:3013 E RENNER RD STE 120
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3577
Practice Address - Country:US
Practice Address - Phone:469-931-0684
Practice Address - Fax:469-931-0712
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26492208D00000X
TXP5553208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice