Healthcare Provider Details

I. General information

NPI: 1033372131
Provider Name (Legal Business Name): BRIAN LIM MARASIGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 S HOUGHTON RD
TUCSON AZ
85748-7632
US

IV. Provider business mailing address

6431 FANNIN ST UT HOUSTON MSB 5020
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 205-436-1005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberN0246
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: