Provider Demographics
NPI:1649581372
Name:MACIAS, OSCAR (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:
Last Name:MACIAS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 S LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4730
Mailing Address - Country:US
Mailing Address - Phone:512-443-7534
Mailing Address - Fax:512-443-0447
Practice Address - Street 1:10401 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5712
Practice Address - Country:US
Practice Address - Phone:512-634-2252
Practice Address - Fax:512-634-2271
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist