MEDICARE: MARQUIS BIAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1033642889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARQUIS BIAS

Provider Business Mailing Address
First Line	:	900 MYRTLE AVE APT 2302
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79901-1673
Country	:	US
Telephone Number	:	951-858-4020
Fax Number	:

Provider Business Practice Location Address
First Line	:	21275 LIGHT INFANTRY AVE
Second Line	:
City	:	FORT BLISS
State	:	TX
Zip	:	79908
Country	:	US
Telephone Number	:	951-858-4020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2017
Last Update Date	:	11/04/2022

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