Provider Demographics
NPI:1548325582
Name:MCCANN, GEORGIA ANNE-LEE (MD)
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:ANNE-LEE
Last Name:MCCANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 FLOYD CURL DR FL 5
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3931
Mailing Address - Country:US
Mailing Address - Phone:210-450-9500
Mailing Address - Fax:210-450-6027
Practice Address - Street 1:8300 FLOYD CURL DR FL 5
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3931
Practice Address - Country:US
Practice Address - Phone:210-450-9500
Practice Address - Fax:210-450-6027
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6866207V00000X, 207VX0201X
PAMT188188207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX325214002OtherMEDICAID CSHCN
TX325214001Medicaid
TX303674YK00Medicare PIN