Provider Demographics
NPI:1578561338
Name:ALQUIZA, MARK (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:ALQUIZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:427 W 20TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2430
Mailing Address - Country:US
Mailing Address - Phone:713-868-4433
Mailing Address - Fax:713-868-4747
Practice Address - Street 1:427 W 20TH ST STE 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2430
Practice Address - Country:US
Practice Address - Phone:713-868-4433
Practice Address - Fax:713-868-4747
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL9067207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173024401Medicaid
TX173024403Medicaid
TX502302YLPSOtherWELLMED PTAN
TXG75115Medicare UPIN