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NPI Code Detail

MEDICARE: DR. MARITA AILEEN NOGUERA OBENZA M.D.

MEDICARE: DR. MARITA AILEEN NOGUERA OBENZA 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
1208000000XPediatrics PhysicianC203774CA
2208000000XPediatrics PhysicianN1805TX

General Provider Information

NPI Number : 1962494153
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARITA AILEEN NOGUERA OBENZA M.D.
Provider Business Mailing Address
First Line : PO BOX 840359
Second Line :
City : HOUSTON
State : TX
Zip : 77284-0359
Country : US
Telephone Number : 832-548-5000
Fax Number :
Provider Business Practice Location Address
First Line : 1344 W CLINTON AVE
Second Line :
City : FRESNO
State : CA
Zip : 93705-3805
Country : US
Telephone Number : 877-960-3426
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 08/31/2025

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