Healthcare Provider Details

I. General information

NPI: 1750221065
Provider Name (Legal Business Name): DOCTORMARCO PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 E NOLANA LOOP STE A
PHARR TX
78577-0100
US

IV. Provider business mailing address

1402 E NOLANA LOOP STE A
PHARR TX
78577-0100
US

V. Phone/Fax

Practice location:
  • Phone: 956-601-0831
  • Fax: 956-601-0833
Mailing address:
  • Phone: 956-601-0831
  • Fax: 956-601-0833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MARCO LOPEZ
Title or Position: OWNER
Credential: MD
Phone: 956-601-0831