Provider Demographics
NPI:1861673469
Name:DONALD C. MCCANN, PH.D., P.C.
Entity Type:Organization
Organization Name:DONALD C. MCCANN, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:210-829-1994
Mailing Address - Street 1:21 LYNN BATTS
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3078
Mailing Address - Country:US
Mailing Address - Phone:210-829-1994
Mailing Address - Fax:210-829-8788
Practice Address - Street 1:21 LYNN BATTS
Practice Address - Street 2:SUITE 11
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3078
Practice Address - Country:US
Practice Address - Phone:210-829-1994
Practice Address - Fax:210-829-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-25
Last Update Date:2007-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-1328103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00449VOtherMEDICARE,GROUP