Individual provider Active NPI

Marquel Renee McCabe, D.D.S.

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1073725693
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22463 Issued in TX
Practice address
2130 NE Loop 410
Suite 225
San Antonio, TX 78217-4659
Phone
(210) 654-9383
Fax
(210) 654-0570
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22463 TX Primary

Addresses

Primary practice location

2130 NE Loop 410
Suite 225
San Antonio, TX 78217-4659

Mailing address

2130 NE Loop 410
Suite 225
San Antonio, TX 78217-4659
Phone (210) 654-9383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150617000582 TX Order and Referring Only - DentistPractitioner - Dentist 3577874536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22463TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Graham Family Dentistry General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1073725693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 NE LOOP 410",
            "address_2": "SUITE 225",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782174659",
            "telephone_number": "210-654-9383",
            "fax_number": "210-654-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 NE LOOP 410",
            "address_2": "SUITE 225",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782174659",
            "telephone_number": "210-654-9383",
            "fax_number": "210-654-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCABE",
        "first_name": "MARQUEL",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.