Provider Demographics
NPI:1073725693
Name:MCCABE, MARQUEL RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARQUEL
Middle Name:RENEE
Last Name:MCCABE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 NE LOOP 410
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-4659
Mailing Address - Country:US
Mailing Address - Phone:210-654-9383
Mailing Address - Fax:210-654-0570
Practice Address - Street 1:2130 NE LOOP 410
Practice Address - Street 2:SUITE 225
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4659
Practice Address - Country:US
Practice Address - Phone:210-654-9383
Practice Address - Fax:210-654-0570
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice