Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 7918 | TX |
Y | 111NI0900X | Internist | 7918 | TX |
N | 111NX0100X | Occupational Health | 1594 | NM |
NPI | 1649284969 |
---|---|
Provider Name | Luis R Marioni |
First Address | El Paso, TX 79926-6786 |
Second Address | El Paso, TX 79925-7548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 17/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U73367 | (02) | TX |