Healthcare Provider Details

I. General information

NPI: 1871872093
Provider Name (Legal Business Name): JOSE MIGUEL URENCIO MARCUE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7719 INTERSTATE 35 S
SAN ANTONIO TX
78224-1469
US

IV. Provider business mailing address

215 E QUINCY ST STE 604
SAN ANTONIO TX
78215-2019
US

V. Phone/Fax

Practice location:
  • Phone: 210-798-4311
  • Fax:
Mailing address:
  • Phone: 210-798-4311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number820-L
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberS2526
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: