Provider Demographics
NPI:1295794618
Name:MCCOY, MATTHEW CHANDLER (PT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CHANDLER
Last Name:MCCOY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8380 WARREN PKWY
Mailing Address - Street 2:SUITE 502
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4198
Mailing Address - Country:US
Mailing Address - Phone:214-618-8075
Mailing Address - Fax:214-618-8055
Practice Address - Street 1:8380 WARREN PKWY
Practice Address - Street 2:SUITE 502
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4198
Practice Address - Country:US
Practice Address - Phone:214-618-8075
Practice Address - Fax:214-618-8055
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist