Organization
MACIEL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA DOULDER (OWNER)
(512) 461-3617
Entity
Organization
Contact information
Practice address
17301 N INTERSTATE 35 STE 101, BUDA, TX 78610-5249
(512) 994-4115
Mailing address
17301 N INTERSTATE 35 STE 101, BUDA, TX 78610-5249
(512) 994-4115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Enumeration date
04/18/2017
Last updated
01/08/2025
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