Maycock, Donovan

Maycock, Donovan is an individual health care provider with primary practice located at 16610 San Pedro Avenue , San Antonio TX 78232. He recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutritionist, Dietary & Nutritional Service Providers / Nutrition, Education. Dietary & Nutritional Service Providers / Nutritionist is his primary health care specialty. Maycock, Donovan can be contacted via phone (210) 778-4781.

Contact Information

Primary practice address
16610 San Pedro Avenue San Antonio TX 78232
Phone: (210) 778-4781
Fax: (210) 545-0444
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X

Profile Details

NPI number 1609151489
LBN Legal business name Maycock, Donovan
Credentials NUTRITIONIST
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2011
Last updated Oct 12th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609151489 NPPES
Other 12138706 CAQH
Other 67752 CAQH

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