Provider Demographics
NPI:1174931414
Name:MACIAS, VERONICA (LSA)
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:
Last Name:MACIAS
Suffix:
Gender:F
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2550
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-2550
Mailing Address - Country:US
Mailing Address - Phone:214-227-2457
Mailing Address - Fax:214-764-0880
Practice Address - Street 1:4407 HANLEY LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-2959
Practice Address - Country:US
Practice Address - Phone:214-227-2457
Practice Address - Fax:214-764-0880
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00760246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8LW524OtherBCBS - UNIVERSAL SURGICAL ASSISTANTS
TX8LX417OtherBCBS - XCITE SURGICAL LLC
TX8LX507OtherBCBS - UNIVERSAL SURGICAL PARTNERS INC
TX8PX953OtherBCBS - US MSO
TXSA00760OtherTEXAS MEDICAL BOARD
TX8LW523OtherBCBS - BLUE STAR SURGICAL ASSISTANTS LLC