Provider Demographics
NPI:1609421247
Name:MAYCARE, PLLC
Entity Type:Organization
Organization Name:MAYCARE, PLLC
Other - Org Name:BLUEBONNET PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYADA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-649-0996
Mailing Address - Street 1:1000 GATTIS SCHOOL RD STE 130
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-2562
Mailing Address - Country:US
Mailing Address - Phone:512-649-0996
Mailing Address - Fax:512-387-3555
Practice Address - Street 1:1000 GATTIS SCHOOL RD STE 130
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2562
Practice Address - Country:US
Practice Address - Phone:512-649-0996
Practice Address - Fax:512-387-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty