Provider Demographics
NPI:1780753905
Name:MACRIS, MICHAEL P (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:MACRIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:915 GESSNER RD
Mailing Address - Street 2:STE 170
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2666
Mailing Address - Country:US
Mailing Address - Phone:713-465-7979
Mailing Address - Fax:713-465-5278
Practice Address - Street 1:1631 NORTH LOOP W
Practice Address - Street 2:STE 240
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1528
Practice Address - Country:US
Practice Address - Phone:713-465-7979
Practice Address - Fax:713-465-5278
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2018-10-15
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Provider Licenses
StateLicense IDTaxonomies
TXG9695208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135272609Medicaid
TX8394M0Medicare PIN
TXF65077Medicare UPIN