Individual
DR. CYNTHIA A MACE-MOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1600 W COLLEGE ST STE 260, GRAPEVINE, TX 76051-2101
(972) 247-8757
(972) 401-9135
Mailing address
PO BOX 674325, DALLAS, TX 75267-4325
(972) 616-4000
(972) 294-3343
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
J9185
TX
207VG0400X
Gynecology Physician
J9185
TX
207VM0101X
Maternal & Fetal Medicine Physician
J9185
TX
207VX0000X
Obstetrics Physician
J9185
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100195003
—
TX
05
—
100195004
—
TX
01
—
100195005
MEDICAID - OTHER
TX
01
—
366462YL7A
MEDICARE - OTHER COUNTY
TX
01
—
8F5170
BCBS
TX
Enumeration date
06/27/2005
Last updated
11/30/2017
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