Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | M0803 | TX |
NPI | 1437133055 |
---|---|
Provider Name | Alastair Glyn Lynn-Macrae |
First Address | Mcallen, TX 78503-1294 |
Second Address | Mcallen, TX 78503-1294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 29/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133483 | SUPERIOR HEALTHPLAN (01) | TX |
147381100 | VALLEY HEALTH PLANS (01) | TX |
173902101 | (05) | TX |
8F3712 | BLUE CROSS/BLUE SHIELD TX (01) | TX |
I31691 | (02) | TX |
P00275125 | RAILROAD MEDICARE (01) | TX |