Provider Demographics
NPI:1841952975
Name:PAZ, MARC
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:
Last Name:PAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 FAIRBURN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-3517
Mailing Address - Country:US
Mailing Address - Phone:318-562-3910
Mailing Address - Fax:
Practice Address - Street 1:223 FAIRBURN AVE STE C
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:LA
Practice Address - Zip Code:71006-3517
Practice Address - Country:US
Practice Address - Phone:318-562-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14621111N00000X
LA1938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor