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MARICELA A MAZUCA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1202 E. SONTERRA BLVD SUITE 102, SAN ANTONIO, TX 78258
(210) 271-3203
(210) 733-6983
Mailing address
1202 E. SONTERRA BLVD SUITE 102, SAN ANTONIO, TX 78258
(210) 305-5075
(830) 730-5082

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA03610
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8N4388
BCBS
TX
Enumeration date
07/18/2005
Last updated
01/15/2020
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