Provider Demographics
NPI:1235776204
Name:MCA MEDICAL, PLLC
Entity type:Organization
Organization Name:MCA MEDICAL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF BILLER
Authorized Official - Prefix:
Authorized Official - First Name:BERNADINE
Authorized Official - Middle Name:MOIRA
Authorized Official - Last Name:SYKSTUS
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, CPCO, CPMA, RRT
Authorized Official - Phone:713-301-5707
Mailing Address - Street 1:PO BOX 9080
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-0134
Mailing Address - Country:US
Mailing Address - Phone:623-974-6611
Mailing Address - Fax:623-974-9434
Practice Address - Street 1:14955 W BELL RD UNIT 9080
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8285
Practice Address - Country:US
Practice Address - Phone:623-628-9349
Practice Address - Fax:623-691-8178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty