Provider Demographics
NPI:1952510729
Name:MACWAR, RACHID RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHID
Middle Name:RYAN
Last Name:MACWAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RACHID
Other - Middle Name:
Other - Last Name:LAKHDAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3350 EXECUTIVE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-6878
Mailing Address - Country:US
Mailing Address - Phone:325-245-4501
Mailing Address - Fax:325-245-4008
Practice Address - Street 1:6833 MEDICAL VIEW LN
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542
Practice Address - Country:US
Practice Address - Phone:813-780-6687
Practice Address - Fax:813-788-6554
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086793207R00000X
TXP0088207RC0000X
IL036128441207RC0000X
FLME128347207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine