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NPI Code Detail

MEDICARE: MARGARET JEAN MCCLENDON PA

MEDICARE: MARGARET JEAN MCCLENDON PA
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
1363AM0700XMedical Physician AssistantPA12575TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA12575OTHERTXTEXAS MEDICAL BOARD

General Provider Information

NPI Number : 1588123194
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET JEAN MCCLENDON PA
Provider Business Mailing Address
First Line : 105 CARRIAGE DR
Second Line :
City : WAXAHACHIE
State : TX
Zip : 75165-6502
Country : US
Telephone Number : 972-935-3258
Fax Number :
Provider Business Practice Location Address
First Line : 1441 S MIDLOTHIAN PKWY STE 100A
Second Line :
City : MIDLOTHIAN
State : TX
Zip : 76065-5597
Country : US
Telephone Number : 469-800-9440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2019
Last Update Date : 07/05/2023

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Directions to “ MARGARET JEAN MCCLENDON PA” Practice Location

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