Provider Demographics
NPI:1023004694
Name:MCLAUCHLIN, GREG STEWART (MD)
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:STEWART
Last Name:MCLAUCHLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7505 MAIN ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4520
Mailing Address - Country:US
Mailing Address - Phone:713-795-0074
Mailing Address - Fax:713-795-5203
Practice Address - Street 1:7505 MAIN ST
Practice Address - Street 2:SUITE 290
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4520
Practice Address - Country:US
Practice Address - Phone:713-795-0074
Practice Address - Fax:713-795-5203
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL61112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K1154OtherBCBS
TX158083901Medicaid
TX3579429OtherAETNA
TXP00006717OtherRAILROAD MEDICARE
TX3579429OtherAETNA
TX158083901Medicaid