MEDICARE: MS. VERONICA MACIAS LSA

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	246ZC0007X	Surgical Assistant	SA00760	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8LW524	OTHER	TX	BCBS - UNIVERSAL SURGICAL ASSISTANTS
2	8LX417	OTHER	TX	BCBS - XCITE SURGICAL LLC
3	8LX507	OTHER	TX	BCBS - UNIVERSAL SURGICAL PARTNERS INC
4	8PX953	OTHER	TX	BCBS - US MSO
5	SA00760	OTHER	TX	TEXAS MEDICAL BOARD
6	8LW523	OTHER	TX	BCBS - BLUE STAR SURGICAL ASSISTANTS LLC

General Provider Information

NPI Number	:	1174931414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VERONICA MACIAS LSA

Provider Business Mailing Address
First Line	:	PO BOX 2550
Second Line	:
City	:	ROWLETT
State	:	TX
Zip	:	75030-2550
Country	:	US
Telephone Number	:	214-227-2457
Fax Number	:	214-764-0880

Provider Business Practice Location Address
First Line	:	4407 HANLEY LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-2959
Country	:	US
Telephone Number	:	214-227-2457
Fax Number	:	214-764-0880

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

Provider Enumeration Date	:	07/30/2014
Last Update Date	:	05/28/2025

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