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General NPI Number Information
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NPI Number | 1043316078
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Entity Type | Individual
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Provider Name | JOE TEMPLE MAHANEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 5788 ECKHERT RD
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City | SAN ANTONIO
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State | TX
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Zip | 78240-3900
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Country | US
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Telephone | 210-699-2119
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Fax |
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Provider Business Mailing Address
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Address Line | 3723 SUNSHINE RANCH RD
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City | SAN ANTONIO
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State | TX
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Zip | 78228-2510
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Country | US
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Telephone | 210-733-9537
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E4496
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License Number State | TX
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