Provider Demographics
NPI:1770562183
Name:MCGEE, MARY KATHERINE (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:MCGEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:705 E MARSHALL AVE
Mailing Address - Street 2:SUITE 3001
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5573
Mailing Address - Country:US
Mailing Address - Phone:903-758-0295
Mailing Address - Fax:903-758-6596
Practice Address - Street 1:705 E MARSHALL AVE
Practice Address - Street 2:SUITE 3001
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5573
Practice Address - Country:US
Practice Address - Phone:903-758-0295
Practice Address - Fax:903-758-6596
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG9915207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00207181OtherRAILROAD
TXTXD98499902Medicaid
E17807Medicare UPIN
TXTXD98499902Medicaid