1174931414 NPI number — MS. VERONICA MACIAS LSA

Table of content: MS. VERONICA MACIAS LSA (NPI 1174931414)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174931414 NPI number — MS. VERONICA MACIAS LSA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACIAS
Provider First Name:
VERONICA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LSA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1174931414
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2550
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROWLETT
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75030-2550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-227-2457
Provider Business Mailing Address Fax Number:
214-764-0880

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4407 HANLEY LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77093-2959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-227-2457
Provider Business Practice Location Address Fax Number:
214-764-0880
Provider Enumeration Date:
07/30/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 246ZC0007X , with the licence number:  SA00760 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8LW524 . This is a "BCBS - UNIVERSAL SURGICAL ASSISTANTS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8LX417 . This is a "BCBS - XCITE SURGICAL LLC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8LX507 . This is a "BCBS - UNIVERSAL SURGICAL PARTNERS INC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8PX953 . This is a "BCBS - US MSO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: SA00760 . This is a "TEXAS MEDICAL BOARD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8LW523 . This is a "BCBS - BLUE STAR SURGICAL ASSISTANTS LLC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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