MEDICARE: DR. MICHAEL LLOYD MCMAHON II M.D.

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	207R00000X	Internal Medicine Physician	K0347	TX
2	208000000X	Pediatrics Physician	K0347	TX

General Provider Information

NPI Number	:	1548240641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LLOYD MCMAHON II M.D.

Provider Business Mailing Address
First Line	:	2940 SPURLOCK RD
Second Line	:
City	:	NEDERLAND
State	:	TX
Zip	:	77627-6313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1003 NEDERLAND AVE
Second Line	:
City	:	NEDERLAND
State	:	TX
Zip	:	77627-2832
Country	:	US
Telephone Number	:	409-344-4466
Fax Number	:	409-600-8525

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

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	01/06/2021

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