Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | BP20039801 | TX |
NPI | 1023362233 |
---|---|
Provider Name | Marlos Ramalho Fernandes |
First Address | Houston, TX 77089-6155 |
Second Address | Houston, TX 77089-6155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2012 |
Last Update Date | 03/03/2021 |