Provider Demographics
NPI:1871561308
Name:AQUINO, MARCOS A (MD)
Entity type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:A
Last Name:AQUINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1903
Mailing Address - Country:US
Mailing Address - Phone:713-943-1640
Mailing Address - Fax:713-943-8639
Practice Address - Street 1:3331 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1903
Practice Address - Country:US
Practice Address - Phone:713-943-1640
Practice Address - Fax:713-943-8639
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8646207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC12916Medicare UPIN
TX00P552Medicare ID - Type Unspecified