Individual
DR. THOMAS MACGILLIVRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6550 FANNIN ST, SUITE 1401, HOUSTON, TX 77030-2717
(713) 441-5200
(713) 793-7428
Mailing address
6550 FANNIN ST, SUITE 1401, HOUSTON, TX 77030-2717
(713) 441-5200
(713) 793-7428
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
150690
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
R0065
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3175014
—
MA
01
—
775509
TUFTS HEALTH PLAN
MA
01
—
8GF597
BCBS
TX
01
—
J18438
BCBS MA
MA
Enumeration date
11/07/2005
Last updated
01/16/2017
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