Individual
ANDREA M MACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2008 SILVER CREEK DR, EULESS, TX 76040-3951
(817) 983-5712
Mailing address
PO BOX 120489, ARLINGTON, TX 76012-0489
(817) 375-5200
(817) 299-1708
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA001094
ME
363A00000X
Physician Assistant
Primary
PA06189
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00436050
RAILROAD MEDICARE
ME
Enumeration date
07/02/2007
Last updated
07/06/2021
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