Provider Demographics
NPI:1134189632
Name:MCCAIG, DELBERT L (DO)
Entity type:Individual
Prefix:
First Name:DELBERT
Middle Name:L
Last Name:MCCAIG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 881
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:TX
Mailing Address - Zip Code:76230-0881
Mailing Address - Country:US
Mailing Address - Phone:940-872-1121
Mailing Address - Fax:940-872-3007
Practice Address - Street 1:1010 N MILL ST
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:TX
Practice Address - Zip Code:76230-3120
Practice Address - Country:US
Practice Address - Phone:940-872-1121
Practice Address - Fax:940-872-3007
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138178210Medicaid
TXF46324Medicare UPIN
TX82580JMedicare ID - Type Unspecified