Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD035740 | DC |
N | 111NI0900X | Internist | MD035740 | DC |
N | 207R00000X | Internist | N3002 | TX |
N | 111NI0900X | Internist | N3002 | TX |
Y | 207RI0200X | Infectious Disease | N3002 | TX |
NPI | 1083632459 |
---|---|
Provider Name | Dr. Brendan Michael De Marco |
First Address | Austin, TX 78760-7366 |
Second Address | Austin, TX 78751-3401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 20/12/2016 |