Provider Demographics
NPI:1841410180
Name:MCCARTHY, TIMOTHY D (PT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:D
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8907 LEVELLAND
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-2907
Mailing Address - Country:US
Mailing Address - Phone:210-861-2638
Mailing Address - Fax:
Practice Address - Street 1:8920 FOUR WINDS DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239
Practice Address - Country:US
Practice Address - Phone:210-495-8788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1079093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist