Healthcare Provider Details

I. General information

NPI: 1790877728
Provider Name (Legal Business Name): KARIN JOHANNA MARIA MCCOY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 03/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7703 FLOYD CURL DR
SAN ANTONIO TX
78229-3901
US

IV. Provider business mailing address

7703 FLOYD CURL DR
SAN ANTONIO TX
78229-3901
US

V. Phone/Fax

Practice location:
  • Phone: 210-567-5625
  • Fax:
Mailing address:
  • Phone: 210-567-5625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number33166
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: