Provider Demographics
NPI:1437133055
Name:LYNN-MACRAE, ALASTAIR GLYN (MD)
Entity Type:Individual
Prefix:
First Name:ALASTAIR
Middle Name:GLYN
Last Name:LYNN-MACRAE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 S CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1294
Mailing Address - Country:US
Mailing Address - Phone:956-687-7896
Mailing Address - Fax:956-994-9694
Practice Address - Street 1:2101 S CYNTHIA ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1294
Practice Address - Country:US
Practice Address - Phone:956-687-7896
Practice Address - Fax:956-994-9694
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0803207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00275125OtherRAILROAD MEDICARE
TX147381100OtherVALLEY HEALTH PLANS
TX173902101Medicaid
TX8F3712OtherBLUE CROSS/BLUE SHIELD TX
TX133483OtherSUPERIOR HEALTHPLAN
TX147381100OtherVALLEY HEALTH PLANS
TXP00275125OtherRAILROAD MEDICARE