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NPI Code Detail

MEDICARE: VICTORIA M MCCAIN PHD

MEDICARE: VICTORIA M MCCAIN PHD
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
1103T00000XPsychologist30569TX
2103TC2200XClinical Child & Adolescent Psychologist30569TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1124163OTHERTXSUPERIOR PIN
275205164617OTHERTXPBH PIN
310013975OTHERTXAMERIGROUP PIN
42241238OTHERTXFIRSTHEALTH PIN
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
600G981OTHERTXBCBSTX GRP PIN
71336198894OTHERGRP NPI NUMBER
886922AOTHERTXBCBSTX IND PIN

General Provider Information

NPI Number : 1073690608
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA M MCCAIN PHD
Provider Business Mailing Address
First Line : 801 7TH AVE
Second Line : REVENUE MANAGEMENT
City : FORT WORTH
State : TX
Zip : 76104-2733
Country : US
Telephone Number : 682-885-4157
Fax Number : 682-885-1903
Provider Business Practice Location Address
First Line : 1516 COOPER ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2710
Country : US
Telephone Number : 682-885-1480
Fax Number : 682-885-3600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 09/11/2025

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Directions to “ VICTORIA M MCCAIN PHD” Practice Location

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