Provider Demographics
NPI:1063531820
Name:MCVEAN, MORRIS CREEDON (DO)
Entity type:Individual
Prefix:
First Name:MORRIS
Middle Name:CREEDON
Last Name:MCVEAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:MORRIS
Other - Middle Name:
Other - Last Name:CREEDON-MCVEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:6515 KEMP BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6515 KEMP BOULEVARD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308
Practice Address - Country:US
Practice Address - Phone:940-692-1220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6549283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A4012Medicare ID - Type Unspecified
TXE20225Medicare UPIN