Provider Demographics
NPI:1740720150
Name:CEDENO MACIAS, LAURA MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MARIA
Last Name:CEDENO MACIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:MARIA
Other - Last Name:CEDENO MACIAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:901 E HACKBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-6502
Mailing Address - Country:US
Mailing Address - Phone:956-618-7100
Mailing Address - Fax:718-901-8704
Practice Address - Street 1:901 E HACKBERRY AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6502
Practice Address - Country:US
Practice Address - Phone:956-618-7100
Practice Address - Fax:718-901-8704
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314397-01208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice