Provider Demographics
NPI:1770897241
Name:MEDICAL CENTER OF MCKINNEY
Entity type:Organization
Organization Name:MEDICAL CENTER OF MCKINNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREATMENT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:INGRID
Authorized Official - Last Name:WILLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:972-548-5499
Mailing Address - Street 1:7101 VIRGINIA PARKWAY,
Mailing Address - Street 2:#834
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5759
Mailing Address - Country:US
Mailing Address - Phone:214-643-3411
Mailing Address - Fax:
Practice Address - Street 1:6404 INTERNATIONAL PKWY
Practice Address - Street 2:2100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-267-1988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52462251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health