MEDICARE: PEGGY MCMAHON, PH.D., P.A.

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	103TC0700X	Clinical Psychologist	25616	TX

General Provider Information

NPI Number	:	1912277310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEGGY MCMAHON, PH.D., P.A.

Provider Business Mailing Address
First Line	:	2301 OHIO DR STE 202
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-3902
Country	:	US
Telephone Number	:	214-923-6778
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 OHIO DR STE 202
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-3902
Country	:	US
Telephone Number	:	214-923-6778
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARGARET MCMAHON
Credential	:	PH.D.
Telephone Number	:	214-923-6778

Provider Enumeration Date	:	01/03/2012
Last Update Date	:	01/03/2012

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