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NPI Code Detail

MEDICARE: RICHARD MARQUEZ PA-C

MEDICARE: RICHARD MARQUEZ PA-C
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
1363AM0700XMedical Physician AssistantPA04118TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18Y0397OTHERTXBCBS

General Provider Information

NPI Number : 1306877766
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD MARQUEZ PA-C
Provider Business Mailing Address
First Line : 927 MCCULLOUGH
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78215-1630
Country : US
Telephone Number : 210-271-3203
Fax Number : 210-733-6983
Provider Business Practice Location Address
First Line : 6800 W IH 10
Second Line : SUITE 200
City : SAN ANTONIO
State : TX
Zip : 78201-2011
Country : US
Telephone Number : 210-271-3203
Fax Number : 210-733-6983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 03/04/2011

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Directions to “ RICHARD MARQUEZ PA-C” Practice Location

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