MEDICARE: MARCOS A. AQUINO, M.D.,P.A.

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	174400000X	Specialist	D8646	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1871561308	OTHER		INDIVIDUAL NPI

General Provider Information

NPI Number	:	1336462340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARCOS A. AQUINO, M.D.,P.A.

Provider Business Mailing Address
First Line	:	3331 FAIRVIEW ST
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-1903
Country	:	US
Telephone Number	:	713-943-1640
Fax Number	:	713-943-8639

Provider Business Practice Location Address
First Line	:	3331 FAIRVIEW ST
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-1903
Country	:	US
Telephone Number	:	713-943-1640
Fax Number	:	713-943-8639

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. MARCOS A. AQUINO
Credential	:	M.D.
Telephone Number	:	713-943-1640

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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