Provider Demographics
NPI:1356784011
Name:MCCLEAN, MARY DORGANT (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:DORGANT
Last Name:MCCLEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:DORGANT
Other - Last Name:DARCONTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6700 WEST LOOP S STE 500
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4120
Mailing Address - Country:US
Mailing Address - Phone:713-791-9966
Mailing Address - Fax:
Practice Address - Street 1:1910 NIEBUHR ST
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5037
Practice Address - Country:US
Practice Address - Phone:713-791-9966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3656208000000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics