MEDICARE: GABRIELA MACIAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1295479	TX

General Provider Information

NPI Number	:	1124671177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELA MACIAS

Provider Business Mailing Address
First Line	:	PO BOX 271049
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77277-1049
Country	:	US
Telephone Number	:	713-339-2273
Fax Number	:	713-339-1130

Provider Business Practice Location Address
First Line	:	6300 WESTPARK DR STE 212
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-7207
Country	:	US
Telephone Number	:	713-339-2273
Fax Number	:	713-339-1130

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2019
Last Update Date	:	07/18/2019

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Directions to “ GABRIELA MACIAS ” Practice Location

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