Provider Demographics
NPI:1851197370
Name:MACIAS, DELLA
Entity type:Individual
Prefix:
First Name:DELLA
Middle Name:
Last Name:MACIAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 LEE BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-1413
Mailing Address - Country:US
Mailing Address - Phone:915-319-3308
Mailing Address - Fax:
Practice Address - Street 1:3500 LEE BLVD STE D
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-1413
Practice Address - Country:US
Practice Address - Phone:915-319-3308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist