Individual
JUAN C MACHANNAFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11970 N CENTRAL EXPY STE 510, DALLAS, TX 75243-3961
(214) 575-5885
(907) 782-4662
Mailing address
11970 N CENTRAL EXPY STE 510, DALLAS, TX 75243-3961
(214) 575-5885
(907) 782-4662
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
P8154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2769820
—
OH
05
—
3810007725
—
WV
05
—
7100080460
—
KY
01
—
P00738774
RAILROAD MEDICARE
KY
01
—
P8154
TEXAS MEDICAL LICENSE
TX
Enumeration date
10/11/2007
Last updated
02/19/2024
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