Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | J1302 | TX |
NPI | 1164434320 |
---|---|
Provider Name | Raul A Marquez |
First Address | Edinburg, TX 78539-8462 |
Second Address | Edinburg, TX 78539-8462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 05/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
084243701 | (05) | TX |
D46955 | (02) | TX |