MEDICARE: DR. MARCOS A. 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	D8646	TX

General Provider Information

NPI Number	:	1871561308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCOS A. AQUINO MD

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	03/16/2010

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