Healthcare Provider Details

I. General information

NPI: 1619904398
Provider Name (Legal Business Name): MARTIN J ARISCO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 BIRDSONG DR STE A
BAYTOWN TX
77521-3205
US

IV. Provider business mailing address

4301 GARTH RD SUITE 100
BAYTOWN TX
77521-3153
US

V. Phone/Fax

Practice location:
  • Phone: 281-422-2020
  • Fax: 281-422-4959
Mailing address:
  • Phone: 281-422-2020
  • Fax: 281-422-4959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD2343
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: