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NPI Code Detail

MEDICARE: DR. KRISTIN KUCERA MARCUM M.D.

MEDICARE: DR. KRISTIN KUCERA MARCUM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology Physician2012-00371NC
2207Y00000XOtolaryngology PhysicianP4782TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053594515
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTIN KUCERA MARCUM M.D.
Provider Business Mailing Address
First Line : 4191 BELLAIRE BLVD STE 200
Second Line :
City : HOUSTON
State : TX
Zip : 77025-1003
Country : US
Telephone Number : 713-795-5343
Fax Number :
Provider Business Practice Location Address
First Line : 4191 BELLAIRE BLVD STE 200
Second Line :
City : HOUSTON
State : TX
Zip : 77025-1003
Country : US
Telephone Number : 713-795-5343
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2007
Last Update Date : 06/10/2020

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