Provider Demographics
NPI:1255193215
Name:MACALISANG, NOEL
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:MACALISANG
Suffix:
Gender:M
Credentials:
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 151716
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78715-1716
Mailing Address - Country:US
Mailing Address - Phone:512-898-9044
Mailing Address - Fax:512-857-1423
Practice Address - Street 1:1001 N GOLIAD ST STE 155
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2505
Practice Address - Country:US
Practice Address - Phone:512-898-9044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician