Individual
DR. CARLOS L MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 PENNSYLVANIA AVE STE 550, FORT WORTH, TX 76104-2148
(817) 250-7190
Mailing address
909 9TH AVE, SUITE 210, FORT WORTH, TX 76104-3903
(817) 335-1131
(817) 335-2514
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
J2172
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105424901
—
TX
01
—
8HT407
BCBSTX
TX
Enumeration date
04/17/2006
Last updated
10/09/2024
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