MEDICARE: MARK QUINONES O.D.

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	152W00000X	Optometrist	8350	TX

General Provider Information

NPI Number	:	1669895215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK QUINONES O.D.

Provider Business Mailing Address
First Line	:	7007 NORTH FWY STE 125
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1326
Country	:	US
Telephone Number	:	713-697-7500
Fax Number	:	713-697-7502

Provider Business Practice Location Address
First Line	:	7007 NORTH FWY STE 125
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1326
Country	:	US
Telephone Number	:	713-697-7500
Fax Number	:	713-697-7502

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

Provider Enumeration Date	:	01/31/2014
Last Update Date	:	01/31/2014

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Directions to “ MARK QUINONES O.D.” Practice Location

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