Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
GUSTAVO MARIN M.D.P.A.
Active
Organization
GUSTAVO MARIN M.D.P.A.
Active
Other names
East Plano Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NOHORA MARIN (OFFICE MANAGER)
(972) 633-8747
Entity
Organization
Contact information
Practice address
2380 E PARK BLVD, SUITE 300, PLANO, TX 75074-5151
(972) 633-8747
(972) 633-8356
Mailing address
2380 E PARK BLVD, SUITE 300, PLANO, TX 75074-5151
(972) 633-8747
(972) 633-8356
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E0540
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0086NL
BLUE CROSS BLUE SHIELD GR
TX
01
—
10027616
AMERIGROUP GROUP NUMBER
TX
01
—
13085
PARKLAND GROUP NUMBER
TX
01
—
434703
AETNA INDIVIDUAL
TX
01
—
8V4390
BLUE CROSS BLUE SHIELD IN
TX
01
—
H08V4391
BLUE CROSS BLUE SHIELD IN
TX
Enumeration date
12/06/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up