1336244714 NPI number — DR. BARBARA D MARINO MD FACOG

Table of content: DR. BARBARA D MARINO MD FACOG (NPI 1336244714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336244714 NPI number — DR. BARBARA D MARINO MD FACOG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARINO
Provider First Name:
BARBARA
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD FACOG
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DOYLE
Provider Other First Name:
BARBARA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336244714
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
425 HOLDERRIETH BLVD
Provider Second Line Business Mailing Address:
SUITE 212
Provider Business Mailing Address City Name:
TOMBALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-364-6614
Provider Business Mailing Address Fax Number:
281-351-6664

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 HOLDERRIETH BLVD
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
TOMBALL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77375
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-364-6614
Provider Business Practice Location Address Fax Number:
281-351-6664
Provider Enumeration Date:
09/13/2006

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: 207VG0400X , with the licence number:  H7724 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 76047220010008 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0688383 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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