Provider Demographics
NPI:1447661939
Name:MARZUKA, ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:MARZUKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEXANDER
Other - Middle Name:
Other - Last Name:MARZUKA-ALCALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:750 N TEXAS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4934
Mailing Address - Country:US
Mailing Address - Phone:346-406-1846
Mailing Address - Fax:346-406-1786
Practice Address - Street 1:750 N TEXAS AVE STE 100
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4934
Practice Address - Country:US
Practice Address - Phone:346-406-1846
Practice Address - Fax:346-406-1786
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4593207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology