Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | G9768 | TX |
N | 208000000X | Pediatrician | G9768 | TX |
NPI | 1366477481 |
---|---|
Provider Name | Dr. Vincent R Macias |
First Address | Mcallen, TX 78501-1402 |
Second Address | Mcallen, TX 78501-1402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 07/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
153910802 | (05) | TX |
D66865 | (02) | TX |
G9868 | MEDICAL LICENSE (01) | TX |