Individual
VIVIANA ISABEL MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
444 CHANNING AVE, SAN ANTONIO, TX 78210-5408
(210) 573-2721
Mailing address
5460 BABCOCK RD STE 120-C, SAN ANTONIO, TX 78240-3901
(210) 573-2721
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
739382
TX
363L00000X
Nurse Practitioner
115978
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1115978
TX
Other
Enumeration date
04/14/2023
Last updated
12/03/2024
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