Provider Demographics
NPI:1386622280
Name:MCCAULEY, MATTHEW B (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:B
Last Name:MCCAULEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21502 MERCHANTS WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2517
Mailing Address - Country:US
Mailing Address - Phone:281-944-2232
Mailing Address - Fax:281-944-2290
Practice Address - Street 1:143 VISION PARK BLVD
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3001
Practice Address - Country:US
Practice Address - Phone:281-363-3443
Practice Address - Fax:936-271-1351
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39778207W00000X
IN01064830A207W00000X
TXM6753207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200424402Medicaid
TX200424401Medicaid
TXDTH 000Medicare UPIN
TX200424402Medicaid
TX8L8209Medicare PIN