MEDICARE: DR. MARCUS MICHAEL AQUINO MD

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	208C00000X	Colon & Rectal Surgery Physician	H4861	TX

General Provider Information

NPI Number	:	1043203128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCUS MICHAEL AQUINO MD

Provider Business Mailing Address
First Line	:	2110 SEABROOK CIR
Second Line	:
City	:	SEABROOK
State	:	TX
Zip	:	77586-1626
Country	:	US
Telephone Number	:	281-474-7171
Fax Number	:	281-474-7177

Provider Business Practice Location Address
First Line	:	2110 SEABROOK CIR
Second Line	:
City	:	SEABROOK
State	:	TX
Zip	:	77586-1626
Country	:	US
Telephone Number	:	281-474-7171
Fax Number	:	281-474-7177

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	01/29/2009

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