Provider Demographics
NPI:1689995185
Name:MACIAS, LAURA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:MACIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S ZARAGOZA RD
Mailing Address - Street 2:UNIVERSITY MEDICAL CENTER
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-6635
Mailing Address - Country:US
Mailing Address - Phone:915-790-5700
Mailing Address - Fax:915-569-3668
Practice Address - Street 1:300 S ZARAGOZA RD
Practice Address - Street 2:UNIVERSITY MEDICAL CENTER
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-6635
Practice Address - Country:US
Practice Address - Phone:915-790-5700
Practice Address - Fax:915-569-3668
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8271207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine