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Individual

DR. BOBBY WAYNE MAREK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
600 NORTH PARK ST, BRENHAM, TX 77833-2610
(979) 836-6153
Mailing address
600 NORTH PARK ST, BRENHAM, TX 77833-2610
(979) 836-6153

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F4241
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036985202
TX
01
10026056
AMERIGROUP
TX
01
106820
SUPERIOR CHIPS
TX
01
4535347A
AETNA
TX
Enumeration date
05/23/2005
Last updated
04/27/2012
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