MEDICARE: MR. OSCAR MACIAS PHARMACIST

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	183500000X	Pharmacist	37595	TX

General Provider Information

NPI Number	:	1649581372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. OSCAR MACIAS PHARMACIST

Provider Business Mailing Address
First Line	:	2501 S LAMAR BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-4730
Country	:	US
Telephone Number	:	512-443-7534
Fax Number	:	512-443-0447

Provider Business Practice Location Address
First Line	:	10401 RESEARCH BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-5712
Country	:	US
Telephone Number	:	512-634-2252
Fax Number	:	512-634-2271

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

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	12/21/2020

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