1730574427 NPI number — HECTOR ROLANDO MARQUEZ DDS

Table of content: HECTOR ROLANDO MARQUEZ DDS (NPI 1730574427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730574427 NPI number — HECTOR ROLANDO MARQUEZ DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARQUEZ
Provider First Name:
HECTOR
Provider Middle Name:
ROLANDO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730574427
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
710 E SAN YSIDRO BLVD STE 128
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN YSIDRO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92173-3123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-831-0437
Provider Business Mailing Address Fax Number:
619-785-3404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
880 AVENIDA LINARES
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAGLE PASS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78852-6506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-831-0437
Provider Business Practice Location Address Fax Number:
619-785-3404
Provider Enumeration Date:
03/31/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  3746208 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)