Provider Demographics
NPI:1528327012
Name:MCCARTY, MICHAEL CHRISTIAN VINCE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHRISTIAN VINCE
Last Name:MCCARTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:CHRISTIAN
Other - Last Name:MCCARTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:200 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3870
Mailing Address - Country:US
Mailing Address - Phone:800-893-9698
Mailing Address - Fax:
Practice Address - Street 1:2500 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4261
Practice Address - Country:US
Practice Address - Phone:361-661-8000
Practice Address - Fax:361-660-5112
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ51009207P00000X
TXR7816207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine