| Doctor Name: | DR. JON P MCCREARY |
| NPI Number: | 1225030802 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 218 |
| Business Practice Address: | 209 Roe St Azle, TX - 760203103 |
| Business Phone Number: | 8172242215 |
| Business Fax Number: | 8173941889 |
| Mailing Address: | Po Box 92096, SOUTHLAKE |
| State: | TX |
| Postal Code: | 760920101 |
| Phone Number: | 8172242215 |
| Fax Number: | 8173941889 |
| NPI Enumeration Date: | 08/12/2005 |
| NPI Last Update Date: | 06/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 218 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AR |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |