Healthcare Provider Details

I. General information

NPI: 1740102284
Provider Name (Legal Business Name): BRYCE ELIZABETH MACATOL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HILLCREST MEDICAL BLVD
WACO TX
76712-8897
US

IV. Provider business mailing address

1307 CISLER DR
MARIETTA OH
45750-9452
US

V. Phone/Fax

Practice location:
  • Phone: 254-202-2000
  • Fax:
Mailing address:
  • Phone: 740-706-2542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: