Individual provider Active NPI

Theresa Marie McKay, M.D.

  • Psychiatry Physician
  • Houston, TX
National Provider Identifier
1710093653
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101235178 Issued in VA
Practice address
2002 Holcombe Blvd
Houston, TX 77030-4211
Phone
(713) 791-1414
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101235178 VA Primary

Addresses

Primary practice location

2002 Holcombe Blvd
Houston, TX 77030-4211

Mailing address

601 S 2ND St
La Porte, TX 77571-5136
Phone (713) 402-8201

Other practice location 1

126 Missouri Ave
MCXP-CCS-CR
Fort Leonard Wood, MO 65473-8952
Phone (573) 596-0417

Other names 1

  • Dr. Theresa Marie Matuszak Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101235178VAMDPsychiatry Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1710093653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S 2ND ST",
            "city": "LA PORTE",
            "state": "TX",
            "postal_code": "775715136",
            "telephone_number": "713-402-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304211",
            "telephone_number": "713-791-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 Missouri Ave",
            "address_2": "MCXP-CCS-CR",
            "address_purpose": "LOCATION",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "postal_code": "654738952",
            "country_code": "US",
            "telephone_number": "573-596-0417",
            "fax_number": "573-596-0524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101235178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "MATUSZAK",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.