Provider Demographics
NPI:1841288362
Name:MCCLUNG, TONY S (MD)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:S
Last Name:MCCLUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1213 HERMANN DR
Mailing Address - Street 2:SUITE 520
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7018
Mailing Address - Country:US
Mailing Address - Phone:713-528-3444
Mailing Address - Fax:713-528-4434
Practice Address - Street 1:1213 HERMANN DR
Practice Address - Street 2:SUITE 520
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7018
Practice Address - Country:US
Practice Address - Phone:713-528-3444
Practice Address - Fax:713-528-4434
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2010-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE6138208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000TA84Medicaid
TX00TA84Medicare ID - Type Unspecified
TXP000TA84Medicaid