Provider Demographics
NPI:1255802179
Name:COLKER, MARCUS (NP)
Entity type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:
Last Name:COLKER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10470 VISTA DEL SOL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7948
Mailing Address - Country:US
Mailing Address - Phone:915-591-2000
Mailing Address - Fax:915-591-2004
Practice Address - Street 1:10470 VISTA DEL SOL DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7948
Practice Address - Country:US
Practice Address - Phone:915-591-2000
Practice Address - Fax:915-591-2004
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139925363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily