1104642511 NPI number — DOC MCCRACKIN, PLLC

Table of content: ANA MERCEDES ROCA MATTEI M.D. (NPI 1144485145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104642511 NPI number — DOC MCCRACKIN, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOC MCCRACKIN, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104642511
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8714 SPRING CYPRESS RD STE 170
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77379-3396
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8714 SPRING CYPRESS RD STE 170
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77379-3396
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
346-808-7084
Provider Business Practice Location Address Fax Number:
346-740-1927
Provider Enumeration Date:
12/02/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCCRACKIN
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
NICOLE
Authorized Official Title or Position:
OWNER/PRIMARY PROVIDER
Authorized Official Telephone Number:
281-323-0092

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)