Provider Demographics
NPI:1669093639
Name:MACIAS, LESLIE VICTORIA (RN)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:VICTORIA
Last Name:MACIAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 W INTERSTATE 10 STE 1500
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3883
Mailing Address - Country:US
Mailing Address - Phone:210-524-7747
Mailing Address - Fax:210-469-4026
Practice Address - Street 1:8000 W INTERSTATE 10 STE 1500
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3883
Practice Address - Country:US
Practice Address - Phone:210-524-7747
Practice Address - Fax:210-469-4026
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX878048163WC1500X, 163WH0200X, 163WH1000X, 163WR0400X, 163WW0000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WW0000XNursing Service ProvidersRegistered NurseWound Care