Individual ProviderThomas MacgillivrayThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansPractice Address6550 Fannin St, Suite 1401, Houston, TX 77030-2717(713) 441-5200PECOS EnrollmentBased on the most recent information from CMS, provider Thomas Macgillivray is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1184605354Provider TypeIndividualFull NameMacgillivray, ThomasTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date11/7/2005Last Updated1/16/2017Contact InformationPractice LocationPractice Address6550 Fannin St, Suite 1401, Houston, TX 77030-2717Phone(713) 441-5200Fax(713) 793-7428Mailing LocationMailing Address6550 Fannin St, Suite 1401, Houston, TX 77030-2717Phone(713) 441-5200Fax(713) 793-7428Provider TaxonomiesCodeDescriptionLicenseCode208G00000XPrimaryDescriptionThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansLicenseR0065TexasCode208G00000XDescriptionThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansLicense150690MassachusettsProvider IdentifiersIDDescriptionIssuerID3175014DescriptionMedicaidIssuerUnlistedMassachusettsID775509DescriptionOtherIssuerTUFTS HEALTH PLANMassachusettsID8GF597DescriptionOtherIssuerBCBSTexasIDJ18438DescriptionOtherIssuerBCBS MAMassachusetts