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General NPI Number Information
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NPI Number | 1023190659
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Entity Type | Organization
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Legal Business Name | JOSE M. MARINA, DO. PA
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 1022 E GRIFFIN PKWY STE. 108
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City | MISSION
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State | TX
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Zip | 78572-2400
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Country | US
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Telephone | 956-583-7111
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Fax | 956-583-7141
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Provider Business Mailing Address
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Address Line | 1022 E GRIFFIN PKWY STE 204
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City | MISSION
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State | TX
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Zip | 78572-2402
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Country | US
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Telephone | 956-432-6351
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | JOSE M. MARINA
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Credential | D.O
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Telephone | 956-458-1013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | K6125
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License Number State | TX
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