Provider Demographics
NPI:1003697285
Name:ALANIZ, MACY LYNEA
Entity Type:Individual
Prefix:
First Name:MACY
Middle Name:LYNEA
Last Name:ALANIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MACY
Other - Middle Name:L
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 HILLCREST MEDICAL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8954
Mailing Address - Country:US
Mailing Address - Phone:254-202-3760
Mailing Address - Fax:254-202-3789
Practice Address - Street 1:50 HILLCREST MEDICAL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8954
Practice Address - Country:US
Practice Address - Phone:254-202-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248913183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician