MEDICARE: MATTHEW CHANDLER MCCOY PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1152030	TX

General Provider Information

NPI Number	:	1295794618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW CHANDLER MCCOY PT

Provider Business Mailing Address
First Line	:	8380 WARREN PKWY
Second Line	:	SUITE 502
City	:	FRISCO
State	:	TX
Zip	:	75034-4198
Country	:	US
Telephone Number	:	214-618-8075
Fax Number	:	214-618-8055

Provider Business Practice Location Address
First Line	:	8380 WARREN PKWY
Second Line	:	SUITE 502
City	:	FRISCO
State	:	TX
Zip	:	75034-4198
Country	:	US
Telephone Number	:	214-618-8075
Fax Number	:	214-618-8055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	09/08/2014

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