Individual
DR. VINCENT R MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
G9768
TX
208000000X
Pediatrics Physician
G9768
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153910802
—
TX
01
—
G9868
MEDICAL LICENSE
TX
Enumeration date
07/11/2006
Last updated
10/07/2009
Update your record
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