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General NPI Number Information
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NPI Number | 1700220761
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Entity Type | Organization
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Legal Business Name | MARCUS R. ANDERSON, MD
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 04/22/2013
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Provider Practice Location Address
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Address Line | 198 NORMANDY ST
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City | HOUSTON
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State | TX
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Zip | 77015-2064
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Country | US
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Telephone | 713-451-6784
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Fax |
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Provider Business Mailing Address
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Address Line | 198 NORMANDY ST
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City | HOUSTON
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State | TX
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Zip | 77015-2064
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Country | US
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Telephone | 713-451-6784
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARCUS RAY ANDERSON
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Credential | M.D.
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Telephone | 713-540-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | P2575
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License Number State | TX
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