Individual
DOUGLAS B MACHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
627 TURTLE CREEK DR, TYLER, TX 75701-1832
(903) 593-2539
(903) 593-0559
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3146
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M1215
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187312701
—
TX
Enumeration date
04/24/2006
Last updated
11/18/2020
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