Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | F1220 | TX |
NPI | 1003870312 |
---|---|
Provider Name | Marino A Rios |
First Address | El Paso, TX 79902 |
Second Address | El Paso, TX 79902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 23/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114556702 | (05) | TX |
1516905 | ECFMG (01) | |
C21088 | (02) |