Provider Demographics
NPI:1053121012
Name:MACIAS, FELICITAS T (APRN, WCS-C, FNP-C)
Entity type:Individual
Prefix:
First Name:FELICITAS
Middle Name:T
Last Name:MACIAS
Suffix:
Gender:
Credentials:APRN, WCS-C, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 S WARE RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-7788
Mailing Address - Country:US
Mailing Address - Phone:956-867-6099
Mailing Address - Fax:
Practice Address - Street 1:2208 PRIMROSE AVE STE F
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4162
Practice Address - Country:US
Practice Address - Phone:956-867-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-11
Last Update Date:2025-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX868736163WW0000X
171M00000X
TX1189681363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No171M00000XOther Service ProvidersCase Manager/Care Coordinator