Provider Demographics
NPI:1255573739
Name:MAXEY, DOUGLAS S (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:S
Last Name:MAXEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:3725 S LAKE FOREST DR
Mailing Address - Street 2:STE 114
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1689
Mailing Address - Country:US
Mailing Address - Phone:817-533-7080
Mailing Address - Fax:817-533-7082
Practice Address - Street 1:5575 WARREN PKWY STE 208
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4063
Practice Address - Country:US
Practice Address - Phone:817-533-7080
Practice Address - Fax:817-533-7082
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0505207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty