MEDICARE: DR. CODY ROBERT MCMAHAN 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	2084P0800X	Psychiatry Physician	BP10046327	TX

General Provider Information

NPI Number	:	1750725701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CODY ROBERT MCMAHAN M.D.

Provider Business Mailing Address
First Line	:	3305 WOOD LAKE DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-1262
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 N 64TH ST
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-4387
Country	:	US
Telephone Number	:	254-772-8055
Fax Number	:

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

Provider Enumeration Date	:	04/22/2013
Last Update Date	:	04/30/2025

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