Healthcare Provider Details

I. General information

NPI: 1649436833
Provider Name (Legal Business Name): ANA CATALINA MACIAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANA CATALINA MACIAS-SEPULVEDA M.D.

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 W HOLCOMBE BLVD
HOUSTON TX
77025-1669
US

IV. Provider business mailing address

8900 LAKES AT 610 DR
HOUSTON TX
77054-2525
US

V. Phone/Fax

Practice location:
  • Phone: 713-422-0000
  • Fax:
Mailing address:
  • Phone: 713-442-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP10030087
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberN5821
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN5821
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: