Provider Demographics
NPI:1053379370
Name:MCCLAY, JOHN ERIC (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ERIC
Last Name:MCCLAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-885-3113
Practice Address - Street 1:11445 DALLAS PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4255
Practice Address - Country:US
Practice Address - Phone:214-494-4150
Practice Address - Fax:972-315-9011
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ0109207Y00000X, 207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103431602Medicaid
F18200Medicare UPIN
TX103431602Medicaid